LPN Leadership Final Lala v2

Leadership Skills training for Lead LPNs
Created: November 2011 Revised:
LEADERSHIP SKILLS TRAINING FOR LEAD LPNS
Table of Contents
PROBLEM/NEEDS STATEMENT .............................................................................................................. 2 AUDIENCE ANALYSIS ............................................................................................................................. 4 PROGRAM EVALUATION PLAN .............................................................................................................. 7 SYLLABUS ............................................................................................................................................ 11 SESSIONS LESSON PLANS..................................................................................................................... 18 Session 1: Overview, Defining role of Lead LPN, and Logging into the Online Course ........................ 19 Session 2: Professionalism and metric .............................................................................................. 21 Session 3: Communication Strategies ............................................................................................... 23 Session 4: Leadership ....................................................................................................................... 24 Session 5: Best Practices Rubric ........................................................................................................ 25 Session 6: Review series and conduct self and series evaluations ..................................................... 26 HANDOUTS.......................................................................................................................................... 27 One Minute Reflection ..................................................................................................................... 28 Logging into Sakai from Albany Med ................................................................................................ 29 Logging into Sakai from home .......................................................................................................... 30 Self-Assessment Rubric for Lead LPNs .............................................................................................. 31 Leadership Skills ............................................................................................................................... 32 READINGS............................................................................................................................................ 33 Required Reading ............................................................................................................................. 34 Supplemental Reading ..................................................................................................................... 34
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Problem/Needs statement
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Albany Medical Center is located in Albany, NY and includes Albany Medical Center Hospital, Albany Medical College (including the Physicians Faculty Practice) and the Albany Medical Center Foundation. I manage training for the Physicians Faculty Practice and the approximately 1700 physicians, clinicians and administrative staff that support the medical operations of the Practice. In late August, I was approached by Liz Anderson, the Administrator for Nursing in the Faculty Practice, to develop a leadership and development program for the six lead Licensed Practical Nurses (LPNs) who work within the clinics as well as those who aspire to the role. I sat with Ms. Anderson to discuss her needs as well as her expectations of the program. Currently there are six lead LPNs within the Practice and they have very little interaction with each other for development, sharing and communication. In Ms. Andersons opinion, this has led to wide differences in the communication and leadership styles of the group. Deficiencies she identified included communication (verbal, written and non-verbal), delegating and direction tasking, as well as overfamiliarity with staff that report to the Lead LPNs. She gave specific examples of favoritism and not leading by example (lateness and scheduling days off) as particular areas of concern. Ms. Anderson envisions a series of sessions that will help to develop these skills in the lead LPNs. I asked Ms. Anderson when she first noticed issues with this group. She noticed troubles six months ago when she was able to focus on what was going on with the Lead LPNs in the clinics. She thinks that if the issues identified earlier are not resolved patient and staff satisfaction survey results will be impacted which could lead to a loss of patients or a higher staff turnover rate. Ms. Anderson spoke of the small nursing community with the greater Albany area, which could be an issue if there is a negative perception of nursing within the Physicians Faculty Practice. Recruitment of nursing staff could be significantly impacted in this situation. The Physicians Faculty Practice is spread out over the main hospital where clinics are located on six floors, as well as ten off-site locations. This leads to little regular contact between staff and clinicians to share ideas, communicate and interact. The Physicians Faculty Practice has also recently finished implementing the first phase of an Electronic Health Record (EHR). With this major initiative underway, the role and function of the LPN is changing within each clinic and because of the geographic separation, the lead LPNs are not growing and developing consistently. An instructional series with this group will accomplish several of Ms. Andersons goals. First, we will be able to bring the group of dispersed lead LPNs together once a month to foster a sense of community and shared role and function. In addition, we can start to discuss their role with each of their clinics and why it is so important to remain professional, communicate effectively, as well as lead by example. I also feel that if instruction is done in an informal manner a peer group of lead LPNs will form. Teamwork and collaboration will naturally start to emerge as a result of the interactions. This will help to meet the goals of the program. This project has the full backing of the leadership of the Physicians Faculty Practice as the Administrators gave their full support of the program to Ms. Anderson in their weekly meeting on September 12, 2011. In the coming weeks I will conduct my audience analysis, develop objectives of the program, create the assessment of the program, and develop the content. Page 3
Audience Analysis
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My program is being developed for the lead Licensed Practical Nurses (LPNs) within the Albany Medical Center Physicians Faculty Practice. Currently there are few opportunities for LPNs to learn new skills outside of the clinical training that is offered by the Center for Learning and Development at Albany Medical Center. To be an LPN, one must graduate from a registered program as well as pass the NCLEX exam. LPNs within the Physicians Faculty Practice are responsible for providing care to patients in clinical setting by collecting and recording patient data (vital signs, health data information, patient health concerns) within the patients electronic health record, educating patients by providing resources and materials to patients and their families, and coordinating referrals. I started my audience analysis in a conversation with Liz Anderson who is the Nurse Administrator for the Faculty Practice. She reported that the lead LPNs are all high school graduates who have completed an accredited LPN program. In addition, the lead LPNs are becoming more and more technology savvy with the adoption of the Electronic Heath Record within the Faculty Practice. She reported the group of lead LPNs is entirely female and their length of time at Albany Medical Center ranges from 6 months to over 10 years. After my conversation with Ms. Anderson, I developed the audience analysis survey. The survey tool I used is one that is available within Albany Medical Center to survey learners. A link can be sent out to each participant via email. The survey can be submitted anonymously or require the participant to login with their network credentials. For my survey, I chose to do the survey anonymously so the lead LPNs would feel they could be truthful. The survey can be accessed using the following link: http://academic.amc.edu/survey/survey/displaySurvey.cfm?formID=2443. I surveyed the lead LPNs using the following questions: 1. 2. 3. 4. 5. 6. 7. 8. 9. How long have you been an LPN? How long have you been in the lead role at AMC? How long have you been at AMC? Have you ever participated in online learning? If so, how was the online learning facilitated? Have you ever participated in a leadership program before? If yes describe the leadership program and your top 3 take-aways. Rate your effectiveness in working in a group setting. Rate your effectiveness at communication. Rate your direct reports' effectiveness at working in a group setting. Rate your direct reports' effectiveness at communication.
I chose each question to help me to identify characteristics of my learners as well as their learning experiences. Questions 1-3 were asked to determine how long my learners have been LPNs, been in the lead role at AMC and their tenure at AMC. The answers to these questions help me to see how recently my learners went through a learning program and the general age of my learners, although their answers are not necessarily indicative of age. Question 4 was asked to determine if my learners had participated in online learning previously and how it was facilitated. I hope to use an online component in my program so having learners familiar with online learning would be beneficial. In question 5, I asked about participation in a leadership program and the top take-aways as I wanted to Page 5

see if my learners were experienced in the topic of leadership and what they might have gained. In the last series of questions I asked my learners several questions about themselves and their direct reports. Questions 6 and 8 ask about group settings. Since part of the perceived issue with this group is how they work within their groups, I thought I would find out how they felt they were within group settings as well as the other LPNs that work for them. In questions 7 and 9 I asked about communication skills, which has also been identified as an issue within this group. There are seven identified lead LPNs and one who aspires to the lead role who were sent the survey via email by Ms. Anderson. By the end of the week the survey was sent, all eight individuals had submitted their surveys. From the survey results, I can see that the lead LPNs have been at AMC for an average of 14.25 years, in the lead role for an average of 5.62 years and have been at AMC for an average of 8.88 years. I can also see that half of the group has participated in online learning previously and only three of my participants have engaged in leadership development previously. I will use this information to help create the learning activities for the group. Recognizing that this group is quite experienced as LPNs helps me to know I must have opportunities for each to be the expert within a discussion or activity and show respect for the knowledge they bring to the group. By knowing that half of my learners have participated in online learning previously, I will spend some time around how to login, navigate and expectations of the group in our first face-to-face session. I might even create a quick tip sheet to assist with this. By knowing only a small subset has participated in leadership development previously, I can look to develop basic leadership training that should not be a repetition of previous learning. Answers to questions related to working within group settings and communication will be reviewed again in the end of program evaluation to see if the learners self-evaluation and evaluation of direct reports changes. It is useful, however, to note that each of the lead LPNs did not rate their direct reports as ineffective or highly ineffective in either area. In designing my survey, I chose to use as few questions as possible. This was in order to decrease the amount of time the learners needed to complete the survey. In retrospect, I should have added a few more questions. Questions that I would ask in the future relate to specific skills of leaders. Those include: professionalism, writing skills, and delegation. I would also like to have asked questions related to the educational level and age of my participants. This also would help me to design my learning to meet the needs of my learners. In addition, as there may be a need for my participants to complete activities outside of their work-day, an understanding of their willingness to devote time outside of work would be beneficial to know as well as I develop learning. I would also add a question to solicit ideas of what my learners would like to gain from the program in order to meet their own personal learning goals.
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Program Evaluation Plan
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS STAKEHOLDERS

Nursing Managers Practice Coordinators Administrators for the Albany Med Faculty Physicians group Physicians Vice-Dean for Clinical Affairs LPNs that report directly to the Lead LPNs
PROJECT SPONSOR
Nurse Administrator
FORMATIVE EVALUATION
Formative Evaluation of the Leadership Skills for Lead LPNs training program is necessary to ensure that the materials and activities that are developed meet the instructional needs of the stakeholders and project sponsor identified above. As materials have been gathered and activities have been developed, I have passed them off to the Nurse Administrator to ensure they are what she was envisioning for the training series. I have developed the following timeline for the Formative Evaluation. At each point in the instructional cycle, the Nurse Administrator and Nurse managers have reviewed and given feedback. List of topics covered September 2011 Learner analysis September 2011 Objectives and assessments October 2011 Syllabus and content outline November 2011 Content and lesson plans December 2011 (still to be done)
As each phase of the instructional design process has concluded I have given the above item to the Nurse Administrator and Nurse Managers for their feedback. It has been vital to ensuring that the instruction meets their needs. One of the assessments is a shared metric that will be inserted into the Lead LPNs Annual Competency Assessment (ACA). It is vital that I have the agreement from the group to include this, which I have gotten. Another assessment requires the learners to meet with their Nurse Manager to develop a professional development plan based upon the completion of the best practices rubric. It is important that the Nurse Managers are aware of what is being taught so they can reinforce the learning in clinic. For the content and lesson plan review I have developed a rubric for the nurse managers to use to assist them in looking at the content. I will give the group the content and lesson plans in early December along with the rubric and ask for it back in mid-December so that I have time to make any requested changes by the time the sessions start in early January. See the last page for the rubric. Page 8

Changes that are identified prior to instruction kicking off by the Nurse Managers will be incorporated, if possible, into the activities and content provided to the learners. For this series, I am not field-testing the instruction and materials as the group that will be participating is so small that finding a sub-set would be very difficult and undermine one of the main reasons behind the series, creating a cohesive team of Lead LPNs. After each session, I will use an online survey that will be sent via email to ask learners if they were able to meet the learning objectives for the session. The learners are not required to submit the evaluation but it will be encouraged. This information will be used to make changes as necessary for the next session or the next time the series is offered. The session evaluation can be found by clicking on the following link: http://academic.amc.edu/survey/survey/displaySurvey.cfm?formID=2514
SUMMATIVE EVALUATION
For the summative evaluation of the Leadership Skills for Lead LPNs training program I plan to conduct evaluations at several points after training. The first evaluation completed by the learners will take place immediately following the last training session through an email survey that will be sent by the instructor. This will give a good point to measure from. The survey that will be used can be found using the following link: http://academic.amc.edu/survey/survey/displaySurvey.cfm?formID=2506. Another survey will be sent to the participants via email three months and six months after the series concludes to see the effectiveness of the training in the long-term. The learners are not required to complete the evaluation but they will be encouraged so that the learning events for future learners will be enhanced. The survey sent at three and six months can be found by using the following link: http://academic.amc.edu/survey/survey/displaySurvey.cfm?formID=2515. This information will be used to improve the learning experience for future groups that participate in the leadership series as well as to identify any learning gaps where instruction needs to be changed. Additionally, if learning gaps are identified, re-education may be required of the Lead LPNs who participate in the series. Another evaluation of the series will take place based upon the shared ACA metric and how the Lead LPNs perform on their annual review. The Nurse Managers will be sharing this result with me once the ACAs are complete in July 2012. In addition, the Nurse Managers will be conducting observations on the Lead LPNs and sharing feedback with me throughout the training series as well as in the following year. This information will be used to determine if the series of sessions was successful in providing the skills needed for the successful Lead LPN. It might also point to other barriers within the clinics that are hindering the Lead LPNs. Data from these summative evaluations will be used to determine if the leadership series will be expanded to the other roles within the Albany Med Faculty Physicians group such as lead Administrative Support Assistants (ASAs) and Practice Coordinators. This information will be shared with the Practice Administrators and Vice-Dean for Clinical affairs to determine the feasibility of expanding the program. The Practice Administrators will see the successes or failures of the program through the performance of the Lead LPNs within their clinics. In addition, I will share at their weekly meeting in late 2012 the evaluation results, the ACA metric results and the professional development plans that were generated at the end of the series of sessions. Page 9
LEADERSHIP SKILLS TRAINING FOR LEAD LPNS PROGRAM EVALUATION RUBRIC

The Leadership Skills for Lead LPN program has four main objectives. After evaluating the content and lesson plans that have been provided to you, please review the objectives and determine if you think the learning activities will meet the objects. Please provide supporting comments for each rating. Any additional comments about the program can be recorded at the bottom of this page. Objective After reviewing a list of best practices of the Lead LPN and discussing with peer group, the learner will reflect upon how effective they are at following the best practices using a rubric that will be developed in-class. The learner will develop a list of responsibilities of the Lead LPN within each clinic to include in their annual competency assessment (ACA). After in-class and online discussion of professionalism, the learner will reflect upon how to increase their own professionalism. The learner will communicate with peers and direct reports in a professional manner as assessed by observation on a quarterly basis. Rating This objective: Will be met by instruction Will be partially met by instruction Will not be met by instruction Comments
This objective: Will be met by instruction Will be partially met by instruction Will not be met by instruction This objective: Will be met by instruction Will be partially met by instruction Will not be met by instruction This objective: Will be met by instruction Will be partially met by instruction Will not be met by instruction
Additional Comments: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________
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Syllabus
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COURSE OVERVIEW
This series of sessions is designed to provide the skills necessary for the Lead LPNs within Albany Med Faculty Physicians group clinics to perform as leaders using professionalism, effective communication and purposeful leadership.
PROGRAM GOALS
Increase professionalism in the Lead LPNs Encourage communication within the Lead LPN group to foster teamwork. Define the role of the lead LPN.
PRIMARY OBJECTIVES
After reviewing a list of best practices of the Lead LPN and discussing with peer group, the learner will reflect upon how effective they are at following the best practices using a rubric that will be developed in-class. The learner will develop a list of responsibilities of the Lead LPN within each clinic to include in their annual competency assessment (ACA). After in-class and online discussion of professionalism, the learner will reflect upon how to increase their own professionalism. The learner will communicate with peers and direct reports in a professional manner as assessed by observation on a quarterly basis.
TIMELINE
This series of sessions will take place in six one-hour sessions held each month starting in January 2012. Between each session, the learners is expected to log in at least 4 times into an online learning course to participate discussion and read journal articles that will be discussed in the following months face to-face session.
DEFINITIONS
Professionalism The level of excellence or competence that is expected of a professional. Professionalism in demonstrated relationships with others in the clinical setting. Any act between at least two people that results in information exchange. A set of behaviors that allows a person to motivate a group toward a common goal.
Communication Leadership
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REQUIRED READING
Talley, L. (2009). Louder than Words. T+D, 63(11), 30-33. Zimmerman, P. (2002) Improving Employee Communication in the Clinical Setting. AAOHN Journal, (50)11, 515-519. Pagana, K. (2010). 7 Tips to improve your professional etiquette. OR Nurse, 4(2), 14-17. radharenu. (n.d.). People Management Skills for New Supervisors and Managers:Golden Lessons. Retrieved November 21, 2011, from Hub Pages: http://radharenu.hubpages.com/hub/PeopleManagement-Skills-Twelve-Golden-Lessons-for-a-Supervisor Reh, J. (2011). How to be a Better Manager. Retrieved Novmeber 21, 2011, from About.com Management: http://management.about.com/cs/midcareermanager/a/htbebettermgr.htm Forster, E., & Thomas, D. (2010, May 10). Eight Thoughts on Elegant Leadrship. Retrieved November 21, 2011, from Keith Ferrazzi: http://www.keithferrazzi.com/leadership/guest-post-eightthoughts-on-elegant-leadership/
SUPPLEMENTAL READING
Gostick, A., & Elton, C. (2009). The Carrot Principle. New York, NY: Free Press. Kouzes, J., & Posner, B. (2007). The Leadership Challenge. San Francisco, CA: John Wiley and Sons. Maxwell, J. (1999). The 21 Indispensable Qualities of a Leader. Nashville, TN: Thomas Nelson.
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OVERVIEW OF SESSIONS
Session 1: Overview and Defining Lead LPN role, online course demo
Objectives After observing an in-class demonstration the learner will be able to demonstrate how to log in to the online learning environment. After discussion with peers, the learner will contribute at least one responsibility of the lead LPNs within a faculty practice clinic. Activities Overview of the LPN Leadership series Why is LPN leadership important - Nurse Administrator / Nurse managers Discussion of responsibilities of Lead LPNs in clinic facilitated by Instructor Demonstration of how to log in to online course with tip sheet provided Assessment of learning Successfully logging into online session at least 3 times before the next face-to-face session as measured on the tracking report from Sakai. Contribute at least one responsibility to the shared Lead LPN responsibility list as observed by instructor. Online follow-up session activities Continue discussion of Lead LPN role in online discussion board Reading articles about Professionalism found in online session o 7 Tips to improve your professional etiquette o People Management skills for new supervisors and managers twelve golden lessons.
Session 2: Professionalism and metric

Objectives After participating in discussion with the instructor and peers, the learner will be able to describe appropriate metrics to include in the Annual Competency Assessment (ACA). After reading articles within the online learning environment about Professionalism, the learner will be able to demonstrate professionalism within their own clinics as observed by the Nurse Managers. Activities Review online discussion of the Lead LPN role with group. Create shared document of responsibilities of the Lead LPNs. This list will be posted online after the session concludes.
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Review articles on Professionalism with group that were read in the online course, and discuss how the concepts covered can be applied to the learners clinical situations. As a group develop metrics for evaluation that will be included in Annual Competency Assessment (ACA) for the Lead LPNs.
Assessment of learning Each learner will participate in discussion of responsibilities for ACA by contributing at least one idea or metric that will be included in the ACA for Lead LPNs. Observation by Nurse Managers of professionalism of each participant in the clinical setting using best practices rubric, which will be developed in session 5. Online follow-up session activities Continue discussion on professionalism facilitated online by the instructor. Reading articles about Communication found in the online session. o Louder than words o Improving employee communication in the clinical setting.
Session 3: Communication Strategies

Objectives After reading articles on communication strategies, the learner will be able describe effective communication strategies that can be used in a clinical setting. Activities Review professionalism discussion from online session. Discuss other behaviors that demonstrate professionalism. Review articles read on communication and as a group discuss how the concepts covered relate to learners experience in clinical situations. Discussion on communication strategies in clinical settings facilitated by instructor. Assessment of learning After discussion the learner will contribute at least one strategy they can use in a clinical setting to communicate effectively. This will be assessed in an end of session one-minute summary how do you communicate professionally? Online follow-up session activities Reading articles about Leadership found in the online session. o Eight Thoughts on Elegant Leadership o How to be a better manager
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS Session 4: Leadership

Objectives After reading articles on leadership within the online learning environment the learner will be able to connect leadership theories with everyday practice activities and list how they are both similar and different in a follow-up in class discussion. Activities Review communication discussion from online session. Discuss leadership theories and common threads of leadership. Create list of similarities and differences between real world and leadership theories individually then share with a partner. Each group will then share 2 similarities and 2 differences with the group. Assessment of learning Learner will participate in a group activity by sharing their own list of similarities and differences between real world leadership and theories of leadership they read. Online follow-up session activities
Learner will start their individual journal of reflection on their own professionalism. Journal will
be a private conversation between learner and instructor and not shared with anyone.
Session 5: Best Practices Rubric

Objectives The learner will demonstrate understanding of concepts covered in previous lessons by contributing to the rubric of best practices for the lead LPN. Activities Review how journal writing went with group. Discuss positive and negative experiences. Review leadership. What leadership demonstrations have they seen in clinic in the last month? As a group, create the best practices that will be included in the best practices rubric. Assessment of learning Each learner will contribute at least one metric to consider to the best practices rubric. Online follow-up session activities Completion of an online journal on their own leadership style. How can they improve? What do they do well? Who is a leader they admire in everyday life, from history?
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS Session 6: Review series and conduct self and series evaluations
Objectives The learner will reflect upon his or her own skills as a leader using the best practices rubric that was developed in the previous lesson. Activities Review journaling from online session. Who are your leadership role models? Review concepts covered in LPN leadership series. Meet in small groups to discuss their own learning outcomes from the series of sessions. Complete best practices rubric that was developed in previous session individually. Complete series evaluation. Assessment of learning Completion of best practices rubric after meeting in small groups to discuss their learning outcomes from the series of sessions. Each learner will meet individually with the instructor and one nurse manager after the series concludes to discuss an individual leadership development plan as well as discuss the finding of each individuals best practices rubric.
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Sessions Lesson plans
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SESSION 1: OVERVIEW, DEFINING ROLE OF LEAD LPN, AND LOGGING INTO THE ONLINE COURSE
Length: 1 hour Objectives
After observing an in-class demonstration the learner will be able to demonstrate how to log in to the online learning environment. After discussion with peers, the learner will contribute at least one responsibility of the lead LPNs within a faculty practice clinic. Syllabus Logging into Sakai Welcome participants and Nurse Managers to the session. Introduce self and have each participant introduce themselves, their clinic, how long they have been at AMC and on interesting fact about themselves. Nurse administrator will introduce the series and tell why it has been developed and why it is important. Instructor should distribute syllabus to each participant as well as the handout Logging into Sakai. Instructor will introduce the topics that will be covered in the series: leadership, professionalism, communication, roles of the Lead LPN and the best practices of a Lead LPN within the clinics. Instructor will go over the expectations of the participants: participate in each session, read assigned articles between sessions, participate in online discussions, and complete assignments such as the journal and personal reflection. Tell participants that today they will start the series by creating list of their responsibilities as a Lead LPN within the clinics. Instructor will record the list on either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator should record it without prejudice to the idea. Tell group that the list will be posted in the online course discussion board for further comment and review. Instructor should then demonstrate how to log in to the online course in Sakai. Demonstration should include how to access Sakai from work (on the network) and from home. Tell group that they are expected to log in at least 3 times prior to the next session, read the two articles and contribute to the online discussion on the responsibilities of Lead LPNs. Successfully logging into online session at least 3 times before next face-to-face next session as measured on the tracking report from Sakai. Page 19
Handouts

Activities
Assessment of learning

Contribute at least on responsibility to the shared Lead LPN responsibility list. Post responsibilities of Lead LPNs that was generated in the session to the discussion board so that learners can contribute additional ideas and start to refine the list. The instructor should facilitate the discussion so that by the next face-to-face session, there is a list that is agreed upon by the group. Each learner should read 2 articles about Professionalism and be prepared to discuss in the next face-to-face session. o 7 Tips to improve your professional etiquette o People Management skills for new supervisors and managers twelve golden lessons.
Online follow-up session activities
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SESSION 2: PROFESSIONALISM AND METRIC

After participating in discussion with the instructor and peers, the learner will be able to describe appropriate metrics to include in the Annual Competency Assessment (ACA). After reading article(s) within the online learning environment about Professionalism, the learner will be able to demonstrate professionalism within their own clinics as observed by the Nurse Managers. Welcome group back, review previous session and the online activities since the last session. Log into online session and show the completed list of responsibilities of Lead LPNs that was created over the last month in the online discussion board. Ask group if they are happy with the list, or if they want to add more to it. When they are satisfied, post to the online course as well as send completed list to Nurse Administrator and Nurse Managers via email. Review the two articles on Professionalism that were read in the online course with the group. As a group, formulate a list of ways that Professionalism can be demonstrated. Instructor will record the list on either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator should record it without prejudice to the idea. Questions to ask to facilitate discussion: o What ways would you add to the list of ways to act professionally? o Is there a difference in how you demonstrate professionalism to peers, direct reports and supervisors? Why would it be important? Tell group that they will next start to develop a metric that will be included in the Annual Competency Evaluation (ACA) for each Lead LPN. This metric will be agreed upon not only by the Lead LPNs but also by the Nurse Administrator and Nurse Managers. Instructor will record the list on either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator without prejudice to the idea should record it. Tell group that the list will be posted in the online course discussion board for further comment and review. Thank group for todays participation, remind them of their responsibilities in the online course log in at least three times and reading the two articles on Communication which will be discussed in the next session. Tell the group that they will also find a copy of the metrics for the ACAs that were discussed today. In the next month they will be working together to finalize the metric(s) online in the discussion board. In the next session, they will determine what the metric will be. Each learner will participate in discussion of responsibilities for ACA by contributing at least one idea or metric that will be included in the ACA for Lead LPNs. Page 21
Activities


Observation by Nurse Managers of professionalism of each participant in the clinical setting using best practices rubric, which will be developed in session 5. Post list of metrics for the ACAs to the discussion board so that learners can contribute additional ideas and start to refine the list. The instructor should facilitate the discussion so that by the next face-to-face session, there is a metric that is agreed upon by the group. Reading articles about Communication. o Louder than words o Improving employee communication in the clinical setting
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SESSION 3: COMMUNICATION STRATEGIES

After reading articles on communication strategies, the learner will be able describe effective communication strategies that can be used in a clinical setting. One Minute Reflection Communication Strategies PowerPoint Presentation Review professionalism discussion from online session. Ask if are there any other behaviors that demonstrate professionalism that they can add to the list that has been generated. When they are satisfied, post to the online course as well as send completed list to Nurse Administrator and Nurse Managers via email. Review articles read on communication in the online session. o Louder than words o Improving employee communication in the clinical setting. Ask if there are any correlations between the concepts covered and their experience in clinical situations. Discuss communication strategies in clinical settings using Communication strategies PowerPoint Presentation. With 5 minutes left, ask the learners pass out One-Minute Reflection handout. Ask the learners to answer the following question in 1 minute as a recap of what was discussed in todays session: How do you communicate professionally? and record on the handout. After 1 minutes, ask each learner to share one strategy they use with the group. Make sure to point out it is OK if the same idea is repeated. Remind the group of their responsibilities in the online course to log in at least 3 times prior to the next session, and read the two articles on Leadership so they will be prepared to discuss leadership in the next session. After discussion the learner will contribute at least one strategy they can use in a clinical setting to communicate effectively. This will be assessed in an end of session one-minute summary how do you communicate professionally? Reading articles about Leadership found in online session. o Eight Thoughts on Elegant Leadership o How to be a better manager Page 23
Handouts and Additional Materials

Activities
SESSION 4: LEADERSHIP
After reading article(s) on leadership within the online learning environment the learner will be able to connect leadership theories with everyday practice activities and list how they are both similar and different in a follow-up in class discussion. Review communication discussion from last session. Ask learners if they have been able to apply any of the concepts discussed. Review the two articles on Leadership that were read in the online course with the group. Ask if they can identify any leadership themes from the articles. Instructor will record the list on either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator should record it without prejudice to the idea. o Eight Thoughts on Elegant Leadership o How to be a better manager Create a list of similarities and differences between real world and leadership theories individually then share with a partner. Ask how leadership theories are different of similar to their experiences in clinical settings. Each group will then share two similarities and two differences with the group. As each group is sharing, record both the similarities and differences either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator should record it without prejudice to the idea Introduce the online session activity for this month. Tell the participants they will be completing a journal writing exercise where they will reflect upon their own professionalism. Each participant will use Microsoft Word and submit to the instructor via email prior to the next session. Assure group that their journal will not be shared with anyone other than the instructor. Learner will participate in a group activity by sharing their own list of similarities and differences between real world leadership and theories of leadership they read.
Activities

Learner will complete their individual journal reflection of their own professionalism using Microsoft Word. Journal will be a private conversation between learner and instructor and not shared with anyone.
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SESSION 5: BEST PRACTICES RUBRIC

The learner will demonstrate understanding of concepts covered in previous lessons by contributing to the rubric of best practices for the lead LPN. Leadership Skills Review how journal writing went with the group. Ask them to share their experiences both positive and negative. Review leadership concepts that were covered in the last session. Ask the group what leadership demonstrations have they seen in clinic in the last month. Tell the group that during this session they will complete a list of best practices in a clinical session for Lead LPNs. This list will be added to the rubric they will be completing in the next session. As each best practice is suggested, ask how this best practice would be measured as highly effective, effective, neither effective or ineffective, ineffective or highly ineffective. Record both the best practices as well as the measurement criteria either a display board or electronically using a computer and projector. As each idea is generated, the instructor/facilitator should record it without prejudice to the idea. Ask the group to choose their top 6-10 best practices to be included on the rubric. When they are satisfied with the Best Practices, post to the online course as well as send completed list to Nurse Administrator and Nurse Managers via email. Introduce the online session activity for this month. Tell the learners they will complete an online journal on their own leadership style. In it, they will answer the following questions: How can they improve their leadership skills? What do they do well? Who is a leader they admire from history? Each participant will use Microsoft Word and submit to the instructor via email prior to the next session. Assure group that their journal will not be shared with anyone other than the instructor. Each learner will contribute at least one metric during the in-class discussion to the best practices rubric. Learners will complete an online journal on their own leadership style using the handout Leadership Skills found in the online course. In it, they will answer the following questions: How can they improve their leadership skills? What do they do well? Who is a leader they admire from history?
Handout

Activities
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SESSION 6: REVIEW SERIES AND CONDUCT SELF AND SERIES EVALUATIONS

The learner will reflect upon his or her own skills as a leader using the best practices rubric that was developed in the previous lesson. Copy of best practices rubric for each learner to complete using the criteria discussed during the last session. Review journaling from online session. Ask each participant to share who his or her leadership role models are. Review concepts covered in series: Leadership, communication, professionalism. Break the group into smaller groups and ask them to share their own learning outcomes from the series. What did they learn? What have they improved upon? What do they still have to improve? Remind learners that in our session last month we created the best practice rubric. They added the best practices that are included in the rubric. We talked about what it would take to be highly effective, effective, ineffective and highly ineffective. Today they will complete the rubric and evaluate themselves based upon what we discussed last month. After this series of sessions is complete, they will be discussing their self-evaluation with their nurse manager as you work together to create their own individual leadership development plan. They should start by choosing a category then complete the rationale column to justify their own evaluation of the best practice. Complete series evaluation (http://academic.amc.edu/survey/survey/displaySurvey.cfm?formID=2506) Tell group the next step will be for each participant to meet individually with their manager to discuss their self-evaluation an to develop a leadership development plan for themselves. Completion of best practices rubric after meeting in small groups to discuss their learning outcomes from the series of sessions. Each learner will meet individually with the instructor and one nurse manager after the series concludes to discuss an individual leadership development plan.
Additional Materials
Activities


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Handouts
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS ONE MINUTE REFLECTION How do you communication professionally?
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS LOGGING INTO SAKAI FROM ALBANY MED
1. Go to the Intranet and scroll to the bottom of the home page. 2. From the Research section, click on Sakai
3. The Sakai login screen will open. 4. Locate User id and Password boxes in the top, right corner.
5. Enter your network ID and password and click on Login. 6. Click on LPN Leadership link, which is located at the top of the screen.
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS LOGGING INTO SAKAI FROM HOME
1. Start your Internet browser 2. Go to the website http://sakai.amc.edu 3. The Sakai login screen will open. 4. Locate User id and Password boxes in the top, right corner.
5. Enter your network ID and password and click on Login. 6. Click on LPN Leadership link, which is located at the top of the screen.
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS SELF-ASSESSMENT RUBRIC FOR LEAD LPNS
Name: ________________________________________________________________________ Clinical Area: __________________________________________________________________ Best Practice Self-Evaluation
I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective I am. Highly Effective Effective Neither Effective or Ineffective Ineffective Highly Ineffective
Rationale
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS LEADERSHIP SKILLS

Use the following page(s) to reflect upon your own leadership skills. You should answer the following questions: How can you improve your leadership skills? What do you do well? Who is a leaders you admire from history?
You should submit your completed reflection to the instructor via email prior to the next session. Your reflection will be confidential and will not be shared with anyone. ______________________________________________________________________________ Name: Clinical Area: Reflection:
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Readings
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LEADERSHIP SKILLS TRAINING FOR LEAD LPNS REQUIRED READING

Talley, L. (2009). Louder than Words. T+D, 63(11), 30-33. Zimmerman, P. (2002) Improving Employee Communication in the Clinical Setting. AAOHN Journal, (50)11, 515-519. Pagana, K. (2010). 7 Tips to improve your professional etiquette. OR Nurse, 4(2), 14-17. radharenu. (n.d.). People Management Skills for New Supervisors and Managers:Golden Lessons. Retrieved November 21, 2011, from Hub Pages: http://radharenu.hubpages.com/hub/People-Management-Skills-Twelve-GoldenLessons-for-a-Supervisor Reh, J. (2011). How to be a Better Manager. Retrieved Novmeber 21, 2011, from About.com Management: http://management.about.com/cs/midcareermanager/a/htbebettermgr.htm Forster, E., & Thomas, D. (2010, May 10). Eight Thoughts on Elegant Leadrship. Retrieved November 21, 2011, from Keith Ferrazzi: http://www.keithferrazzi.com/leadership/guest-post-eight-thoughts-on-elegantleadership/
SUPPLEMENTAL READING
Gostick, A., & Elton, C. (2009). The Carrot Principle. New York, NY: Free Press. Kouzes, J., & Posner, B. (2007). The Leadership Challenge. San Francisco, CA: John Wiley and Sons. Maxwell, J. (1999). The 21 Indispensable Qualities of a Leader. Nashville, TN: Thomas Nelson.
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FUNDAMENTALS //
LOUDER THAN WORDS

By Linda Talley
Youve got plenty of great things to say. Make sure that your body language doesnt betray your message. Every time you take the platform in front of an audience, your body language speaks loudly and clearly. Smile sheets or evaluations wont help if you dont know what your body is saying that your mouth is not. You must understand what you say without words to eliminate mental, physical, and emotional barriers between yourself and your audience members.
If you are experiencing a communication breakdown during a training program, it is crucial to objectively identify the reasons why. Too often, I hear trainers say that a habit originated with another person or with the audience, but is that really true?
To overcome the obstacles that can break a connection with the audience, you need to understand and use body language to your advantage to gain more self confidence, become more productive in front of the audience, and create a bond that brings participants back. Understanding body language is about more than just staying competitive in the training business. Its about creating a powerful advantage, and at the same time, building relationships with your audience members.
Defensive positions Are you using the training manual as a barrier? If you hold it tightly in front of you, people are looking at the barrier rather than at you, and the manual holds more power than you do. I attended a meeting where the president of the group stood in front of the audience for 45 minutes and talked about
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focusing on what you have to say. For many men, putting a hand or two hands in their pockets happens naturally. You see similar gestures on TV. Men should pay attention when an actor puts his hand in a pocket and think about where the eye travels. Is that where you want your audience members eyes to travel when you are training? No. After a half day of training, when your feet, legs, and lower back are tired, should you sit down on a table, in a chair, or cross legs or ankles? Its comfortable, no doubt, but what message does it send to your audience? Crossing your legs is a defensive position used for comfort. Its comfortable, but its also a barrier to the audience. Take a seat, if necessary, but keep your feet flat on the floor, with your legs and ankles uncrossed. Women who wear a dress and sit down during the training should consider wearing pants so it will be easier to sit without crossing your legs.
the benefits of joining the organization. The entire time, she grasped a notebook to her chest. She never referred to it, never opened it, and there was no reason for her to be clinging to it. After her presentation, I asked her why she took the notebook to the platform with her, and she said she didnt realize she had it. This is a defensive position that has become an unconscious habit. You can certainly hold the manual, but keep it to your side or on a table or lectern. Refer to it as often as you need, but dont let it block the connection with your audience.
Going to extremes Are you holding your training guide in one hand and crossing the other arm over your chest? Many people say it feels comfortable to cross one arm over the chest and hold it in this manner. Again, it may be comfortable for you,
but it sends a nonverbal message to your audience that could distract them from hearing what you are teaching. I have observed both men and women use this defensive position, and theres no need for it. If the arm holding the manual needs support, make your arm stronger by lifting weights. If you dont think you must go to that extent and you want to do something with your other arm or hand, other than simply letting it hang by your side, here are some suggestions: Put your other hand on your hip. It takes up more space, and you are perceived as more powerful. Rest it on the lectern or podium, or alternately, rest it on the back of a chair. Do not put your hand into your pocket or behind your back. When you do either one of these, people will be wondering whats behind your back or whats in your pocket rather than
The eyes have it What about eye contact? Eye contact can be used to control audience members or to make a connection with the audience. Which way do you use it? Avoiding eye contact is a way to discipline rude audience members. Its also the way a novice trainer handles the pressure of the platform. It is generally accepted that the person who maintains the longest eye contact is viewed as the person in charge. Two to four seconds of eye contact is acceptable to make an audience member feel visible. If you gaze longer, it could mean intimidation or intimacy. Both are acceptable, yet as a trainer, which message do you want to convey? Watching where you place your hands Hand movements are another source of audience communication. Pointing a finger is never a good idea, even if you are calling on an audience member or identifying someone with a question. The hands should always be in the palm-up position when doing this. It may feel awkward at first, but facilitators should adjust to it. This is why
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FUNDAMENTALS //
Understanding body language is about more than just staying competitive in the training business. Its about creating a powerful advantage, and at the same time, building relationships with your audience members.
many people, particularly politicians, hold their thumb next to the forefinger to avoid pointing. If you want to make a point, make sure the palms face the audience. If you use this metaphoric gesture too often, it will wear out your audience members, so use it only to make key points. If you want to get others involved, use community hands whereby the palms are facing upward or toward each other as you motion toward your audience.
Staying on message You must be on the lookout for mixed messages, not only when you are on the platform but whenever you leave the house. For example, while checking into a hotel the night before a conference, a speaker at the front of the line was shouting at the desk clerk, demanding that he better get a nonsmoking room or else. Imagine the impression any conference attendees in his session might take away from that episode. You never know when and where you will run into your audience members, and you dont want to leave them with a mixed message. Whenever you leave
your house, keep in mind that you are on the platform, and your audience members may be watching you. Make certain that they see only what you want them to see. Nonverbal communication is unique to each training session and each audience, and it is used as a way to create a community, because it builds relationships. You may have habits that make you feel comfortable in the training room, but do they make your audience members feel comfortable so that you can make the emotional connection with them? When you understand the nuances of body language, you become influential and you become a better trainer because you know how to make the connection with your audience.
Linda Talley is a Houston-based speaker and executive coach and contributor to the 2010 Pfeiffer Annual Training Manual; linda@ lindatalley.com.
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NOVEMBER 2009 | T+D | 33
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FEATURE ARTICLE Clinical Perspectives
Improving Employee Communication in the Clinical Setting

A Nurses Perspective
by Polly Gerber Zimmermann, MS, MBA, RN, CEN
lient satisfaction is desirable. Clients who are content with their health care are more likely to comply with the required treatment regimen. A 5% increase in satisfaction can result in a 25% increase in business (Coile, 2002). Nursing feels more rewarding when the provided care is appreciated. There are some indications that consumer satisfaction with overall health care is improving. In 2001, 46% were extremely or very satisfied with their care, up from 39% in 2000 (Coile, 2002; Employee Benefit Research Institute, 2001). However, these findings still mean a majority of individuals are dissatisfied. What can occupational health nurses do to improve that?
about the clients situation or therapeutic interpersonal communication techniques. They are approaches universally interpreted as communicating care and competence. Using them affects client satisfaction. INITIAL CONTACT
Greet with a Smile
CUSTOMER SERVICE PRACTICES AND TECHNIQUES Increasingly savvy and informed clients judge health care providers competence by customer service type skills, not clinical skills, approximately 85% of the time (Herzlinger, 1997). The majority of nurses have clinical competence. One researcher found that, as a whole, occupational health nurses scored higher in clinical competency assessments than the average experienced nurse (personal communication, Dorothy J. Del Bueno, June 21, 2002; Del Bueno, 2001). However, that is no longer enough. Nurses need, but are not routinely educated or trained in, public relations skills. These are basic practices and techniques commonly applied in service industries. They are more than expressions of a personal emotional feeling
In an everyday busy pace, it is easy for staff to inadvertently feel as if the newly arriving employee is a bother, rather than the reason for the occupational health services existence. An inadequate initial acknowledgment can result in employees mistakenly feeling as if they were treated coldly. Boothman (2000) explains how to make a good first impression. Anyone can give an impression that they are sincere, safe, and trustworthy within the contacts first 3 to 4 seconds. It involves five steps: Be open. Beyond a mental attitude, physically keep the heart and body area uncovered and facing toward the person (e.g., no crossed arms or legs). Make eye contact. Be the first to make eye contact. Beam. Immediately light up with a smile. Say Hi. Use a pleasant tone. Lean. Initiate an almost imperceptible forward tilt. It subtly indicates interest. Through focus and discipline, anybody can perform this welcoming greeting, even if they have a headache and are running 30 minutes behind schedule.
Indicate Immediately if there is a Delay
ABOUT THE AUTHOR

Ms. Zimmermann is Instructor, Department of Nursing, Harry S. Truman College, Chicago, IL; and former Associate Nurse, American Airlines, OHare International Airport, Chicago, IL and former Staff Nurse, Emergency Department, Swedish Covenant Hospital, Chicago, IL. E-mail: pzimmermann@ccc.edu.
People do not like to waste time. Keeping people waiting can be interpreted as a sign of disrespect for them and their time. Everyone wants and deserves respect. Employees should be informed right away if there is a wait, and if so, the approximate length. For example, the nurse may say, I need to finish this and I can be with you in about 2 minutes. If there is a significant delay
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(i.e., 60 minutes or more), some offices offer the chance for the arriving employee to reschedule or to leave and come back at a later set time. Employees rarely do, but then they have a choice and feel the value of their time was at least acknowledged. The nurse should avoid saying, just a second... This is one of the many false phrases people commonly use. However, it still resonates at some level as untrue (which it is). It is important to keep the interaction honest.
Avoid Triggers
Pay Attention
It is important to give the employee full attention and look them in the eyes, particularly while they first describe the reason for their visit. This is the time when they are expressing what they feel is significant. Many nurses are excellent multi-taskers. However, when the nurse is writing, changing the table paper, or putting away supplies at the same time, employees may believe the nurse is not listening.
Repeat the Reason for the Visit in the Employees Words
Some of the classic behaviors that irritate waiting people are when staff members are laughing, eating, or standing around doing nothing. Nurses should try to do these things out of sight and earshot. Employees do not know if staff members have worked through their lunch break or have done everything they can do before the desired service is available. Some individuals may think others are laughing at or talking about them. Their personal perception may become their reality.
Handle Phone Interruptions
If an employee wants to speak to a staff member who is on the phone, that staff member should signal by holding up a finger as an acknowledgment while completing the phone conversation. This helps employees feel as if they are not ignored. On the other hand, if taking a call interrupts the employees conversation, the employee should be offered an explanation afterwards, such as, I have been unable to reach the employee earlier to give him some urgent, essential information. Most individuals are tolerant because they would want the same attention if they needed it. INITIAL INTERVIEW
Use Names
Employees feel heard when the nurse echoes their statement (i.e., therapeutic reflection). A tendency may exist to summarize or translate what the employee says because that is what nurses usually do during documentation. For instance, if the employee says, I banged up my arm, a nurse may reply, Youve bruised your arm (interpreting what is being visualized). Meanwhile, the nurse is charting 1 inch 2 inch purplish blue ecchymosis on right lateral forearm after accidentally bumping a metal bar 40 minutes PTA. The employee may not feel understood because the words were changed. The employee may repeat the initial statement for clarification, No, I banged up my arm.
Praise What Employees Have Done Right
Many people are sensitive to criticism. Starting the initial contact with a positive remark is helpful. Even if an employee did everything else wrong, the nurse can say, Im glad you came in so we can help [or can take a look at that]. Opportunities will be available later for any needed corrective teaching.
Use Scripted Phrases
Names are a precious commodity. The nurse should say employees names often. The nurse can extend their hand and tell employees their name. It is the American cultures established, respected ritual to positively initiate interactions.
Speak Slowly
The nurse should speak at a normal pace. It is easy to start speaking with a quicker tempo, especially during a hectic day. Hurried speech, though, is easily misinterpreted as the nurse rushing the care. Some individuals lose some hearing each year after age 50. It is estimated there is some degree of hearing loss (often undiagnosed) in approximately 30% of adults ages 65 to 74. Simple techniques, such as speaking at a normal rate and slightly louder while facing the individuals, help them accommodate (Hensley, 1996).
Sit Down
It is difficult to emote proper emotions or create new clever statements for each and every employee. Established, reassuring phrases, known to work in communicating care and value, can be used. Examples include: That looks sore. Im sorry this happened to you. It sounds like it has been a difficult time for you. Well take care of that for you. Some nurses believe employees will think the nurse is a fake when using cliches or obvious sentiments. Yet, some scripted phrases are socially acceptable, such as the stock phrases, Im sorry for your loss or my sympathy is with you when discussing death. The tone of voice conveys the intent behind the familiar words. Using planned phrases helps the nurse remember to acknowledge the employees experience. Experimentation with phrases helps the nurse decide which ones feel right and evoke a positive response from this employee population. Spontaneous thoughts always can be added.
Know What Employees Want
Employees will perceive the interaction lasted three times longer when the health care provider is sitting. The worst position to assume while talking to an employee is standing near, or in, a doorway.
Employees may have an idea of what they want or need. For instance, an employee may present with the classic symptoms of muscle strain and demand an xray to find out what is wrong. An RN knows that an
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x-ray will not show the muscles, and, therefore, would be worthless. However, an employee may ask for an xray anyway. Failing to give employees what they thought they needed may be interpreted as not receiving good care. This does not mean all requests should be granted. However, employees should receive an explanation to correct any misperceptions. Nurses should avoid the word but and no in discussions. Adults do not appreciate being told they cannot do something. The word and should can be used instead; for instance, We could get a skull x-ray for that bump on the head and [not but] we need to discuss whether that is the best option for you. Employees can be told the rationale for interventions (or their omission). The nurse might quote research, statistics, or even show the employee a reference page. For example, the nurse may say, A lumbar spine series delivers a gonadal dose equivalent to a daily chest x-ray for 6 years, yet in one study there was only 1 positive in 2,500 x-rays (Weitz, 1999). This usually works to satisfy initial demands for x-rays of new musculoskeletal back pain. TREATMENT
Start Treatment Immediately
Pointing out the benefit of routine nursing actions can be used to facilitate effective presentation. When closing the door or pulling the curtain for confidentiality, the nurse can tell the employee, I am now closing the door because I want to insure your privacy. Similarly, the nurse can help employees perceive the appropriate value of the care they receive. For example, the nurse can initiate a discussion to make clear the ratio of burdens to benefits of care. The nurse might say, Sorry you had a wait when you arrived with your injury, but it was still a lot less time than it would have taken if you had gone to the emergency department.
Create a Happy Ending
In U.S. culture, it is customary to convey good wishes at the conclusion of the interaction. It seems rude if someone just hangs up the phone without saying goodbye. Possibilities for the end of a clinic visit include: Be well. Hope everything works out for you. See you at your follow up visit. Bye now. One nurse shares that employees seem to enjoy it when, as they leave, she laughingly says, Thanks for shopping [the name of the company]. People remember first and last impression: Make the final moments pleasant. WHEN PROBLEMS ARISE
Point of Intervention
As often as possible, the nurse should start to treat new injuries before requiring all paper work to be completed. Having ice on a swollen ankle minimizes feelings that all they care about is the paperwork. Being as liberal as possible with fluids and pain relief can be helpful. These two key interventions are the most likely to make the employee feel better.
Involve the Employee in the Plan
No one likes to feel out of control. Being in the unfamiliar health care environment is uncomfortable for some. It may be difficult for the employee to passively allow the nurse to perform activities related to the treatment. The nurse should explain what will happen beforehand. Physical assessments should be shared as they are obtained (e.g., blood pressure, lung sounds) and used as teaching opportunities. The purpose of an ordered diagnostic test should be explained.
Use Presentation
Often, one can sense when there is a problem beginning. Confronting the festering atmosphere to stop it from escalating is helpful. It is easy to get wrapped up in ones own version of an incident. Sometimes a staff member is busy writing out the defense for the supervisor while the employee is still present and the problem could possibly be fixed. It is important to acknowledge there has been a breakdown, and work to resolve the issues. An example is to say, I am sorry I was abrupt. I was distracted because it has been busy today. Lets go forward from here and get you the care you need. It can feel awkward, but it takes a lot less time and energy than dealing with the unresolved complaint later. If necessary, the nurse can try offering a reasonable alternative action or another person to care for the employee.
Blameless Apology
Nurses are conditioned to perform their duty in a matter of fact fashion. Adding a little sell to the action can help the perceived effectiveness and employees reaction. The nurse can be generous with hands-on high touch interventions people crave in the current high tech world. One nurse has a 5 minute routine she performs for anyone whose condition warrants lying down to rest (e.g., nausea, vomiting, migraine). She encourages employees to breathe out anxiety while massaging their shoulders, assisting them in positioning with a warm blanket and turning out the light. She comments on the known effectiveness of the medication she is administering. As a result, the employees receiving care from this nurse report they feel much better as a result of her nursing care.
When someone is unhappy about something beyond any personal control, the nurse can offer an apology about the fact that they are having a problem. For example, Im sorry you were not able to schedule your appointment at a convenient time. Blame is neither personally assumed nor projected onto the employee. There is only understanding and regret for an expressed difficulty. Having the problem acknowledged often diffuses anger.
Broken Record
Employees may not like what they are being told. Thus, they ask again hoping for a different answer. The tendency is to engage in a vicious cycle, trying to reiter-
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An Example of Service Recovery

A designated person (often a manager) calls the employee making the complaint. This individual should:

Start with a blameless apology. Listen to the full story while taking notes. Not interrupt the employee. Not correct the employee. Allow the employee to express feelings of being wronged. Repeat the key points in the designated persons own words to express comprehension of the employees perspective. Say, We want to make this situation right for you, when the employee is completely finished. Ask the employee what the employee would like done now.
at this time (or you do not have the authority), but you will talk to the involved people. Carry through with the commitment, and then contact the employee with the complaint again. Let them know the conversation(s) that took place and provide any appropriate additional information. Indicate this type of situation will continue to be monitored, as is probably occurring anyway. Usually, employees are appeased because they believe their concerns were taken seriously.
Learn from Complaints
Everyone appreciates compliments. However, it is important to avoid the tendency to completely discredit complaints because they are a rich source of potential improvements. The nurse can specifically ask employees, as well as individuals with complaints, What is one thing we could be doing better? CASE SCENARIOS
Employee Wants Care for a Personal Situation
Mayer (1999).
ate it differentlyoften accompanied with some irritationin a way others will eventually accept. It does not work because the problem is with the information, not the explanation. Instead, it may be helpful for the nurse to continue to repeat the same information, in the same way, in a matter of fact tone of voice. Eventually, the employee realizes, no matter what is said by them, the information will not change. An example of an interaction might include:
I understand you are unhappy that you have to wait, but it will be another 15 minutes. This is ridiculous! I cant believe the inefficiency around here. I should be seen quicker than that. I understand you are unhappy that you have to wait, but it will be another 15 minutes. Something should really be done about this place! Who is in charge around here anyway!? I understand you are unhappy that you have to wait, but it will be another 15 minutes.
Service Recovery
At times when there has been a major breakdown, an employee files a formal complaint. Deliberate action is needed now. Service recovery is an established business practice that attempts to repair damage done in a customer relationship. It can be effective if it is done in a timely manner to the complainers satisfaction, as demonstrated in the Sidebar. Most employees will indicate appreciation for the call and just want someone to be aware of the problem. If they make an irrational demand, such as, Fire all the staff, deflect. Indicate you will not be able to do that
Newer employees often have trouble conceptualizing that occupational health services (OHS) does not take care of all of their health care needs. It is a unique variance: No other health care source tells clients their needs cannot be met because of the problems time of onset or origin. (The organization can also work toward providing expanded services including non-occupational health services.) Thus, the new employee may become upset. Suggestions include: Let the employees first tell their whole story. Otherwise, they feel cut off and focus their energies on telling the rest of the story so the decision will change. Use the phrase, We are not allowed to care for this health need. This is more preferable phrase than We are unable to... which insinuates a lack of capability. Nurses are capable of caring for the particular health needit is just not in the job description. State up front the anticipated employees negative reaction. For instance, I know it probably seems as if I am disregarding your problem. or I know it is frustrating and confusing to not receive this routine care here. The nurse has shown empathy. State rejection with a tone or an expression of regret. Otherwise, the denial is sometimes misconstrued as staff being lazy, refusing care, or not caring about the problem. Provide an alternative option. Besides the traditional see your private health care provider, try to give the employee something. It can be an assessment (e.g., take their temperature), one tablet of an over the counter medication, or even a health care tip (e.g., drink fluids, try tea with honey and lemon). Thus, the experience is not viewed as worthless.
Employee Refuses a Needed Higher Level of Care
A male employee who is obese has chest pain and does not want to go to the hospital. A middle-aged man with a history of kidney stones has intermittent writhing and diaphoresis, but wants to continue to work.
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The employee can be declared unsafe to continue to work and be pulled from the job. The OHS staff can require a medical clearance from the personal health care provider before allowing the employee to resume work. Yet, there is also a strong desire to for the employee to receive the proper treatment now. The nurse can use the broken record technique, with a concerned tone, to reinforce the recommendation. A successful approach is to say, You came here because you have concern about this symptom. I share that concern. Lets get you the care that you need. Sometimes the employee is in denial. The repetition can help penetrate the shell. Employees may also have an internal fear that they are overreacting and will appear foolish. Reassuring them it is a legitimate need, even if the eventual cause is benign, helps lessen the resistance. If nothing else, they can defend their action by saying, The OHS staff thought I should go.
Using the OHS to Deal with Work Relationship Problems
I N
S U M M A R Y
Improving Employee Communication in the Clinical Setting

A Nurses Perspective
Zimmermann, P.G.
AAOHN Journal 2002, 50(11), 515-519.
1 2 3
Integrating public relations techniques with clinical competence promotes employee satisfaction (and appreciation). Described techniques improve the employees clinic interaction, perception of the nurses understanding care, and involvement in the treatment. Nurses should incorporate the service industrys tricks of the trade to deal with dissatisfied employees. These include point of impact intervention, blameless apology, and broken record.
Occasionally, there can be a disagreement between an employee and supervisor, and a health care excuse might become a convenient scapegoat. For example, an employee may say he was too ill to work safely when he was given an assignment he did not like and the supervisor sent him to OHS for an evaluation. The employee was not happy unless the OHS staff agreed he was ill. The supervisor was not happy when the staff let him get away with that. The key is to remain matter of fact. Nurses are not hired to be a friend, job counselor, or disciplinarian. The nurse makes the decision according to the employee s statements. However, the nurse needs to literally transcribe the statements, particularly about being unsafe. If the pattern continues, a formal health care provider evaluation of the employees health status or a health care leave of absence can be required. CONCLUSION Sometimes increasing employee satisfaction is mistakenly seen as a need to get nicer OHS staff. Instead, it is usually training the existing staff to use proven service industry techniques. Employees expect and assume staff clinical competence. However, they will treasure caring competence, which is manifested in how the expertise is delivered. One medical director resolved an emergency department situation by instituting a customer service focus for all staff. They decreased client initiated complaints by 70%, and increased client compliments by more than 100%. The department currently has a ratio of five compliments to one complaint from any client initiated contact (e.g., anecdotal comments, e-mail, phone calls, letters). In the customer service surveys, the clients ranking of the physicians and nurses clinical skills improved dramatically. Yet, interestingly, these changes all occurred with the same staff members (Mayer, 1998, 1999).
Regardless of clients responses, nurses will continue to perform their professional duty to provide quality delivery of health care. However, it is more enjoyable when employees recognize and acknowledge the valuable care provided by the OHS staff. Recognition of and satisfaction with quality occupational health care delivery can be attained by integrating public relation techniques into practice. REFERENCES
Boothman, N. (2000). How to make people like you in 90 seconds or less. New York: Workman. Coile, R.C. (2002). Futurescan 2002: A forecast of healthcare trends 2002-2006. Chicago: Health Administration Press. Del Bueno, D.J. (2001). Buyer beware: The cost of competence. Nursing Economic$, 19(6), 250-257. Employee Benefit Research Institute. (2001, October 9). American satisfaction with health care rises, but pessimism about future remains [Press release]. Washington, DC: Employee Benefit Research Institute. Hensley, L.S. (1996). Sensory function in Lueckenotte AG gerontologic nursing (pp. 813-852). St. Louis: Mosby. Herzlinger, R. (1997). Market-driven health care. New York: The Free Press. Mayer, T.A., Cates R.J., Mastorovich, M.J., & Royalty, D.L. (1998). Emergency department client satisfaction: Customer service training improves client satisfaction and ratings in physician and nurse skills. Journal of Health Care Management, 43(5), 427-441. Mayer, T.A., & Zimmermann, P.G. (1999). ED customer satisfaction survival skills: One hospitals experience. Journal of Emergency Nursing, 25(3), 187-191. Weitz, M. (1999). Back pain, lower. In M.A. Davis, S.R. Votey, & P.G. Greenough In Signs and symptoms in emergency medicine: Literature-based approach to emergency conditions. St. Louis: Mosby.
519
New Nurse Notes
7 tips to improve your professional etiquette

By Kathleen D. Pagana, PhD, RN
When you think of the qualities you need for success in your nursing career, you probably think of clinical, leadership, and management skills. But another skill cant be ignored: professional etiquette, a critical link for career success. Etiquette is more than good manners; its a tool for cultivating good relationships. More than most careers, nursing is characterized by professional relationships among different people in numerous settings. Based on the guiding principles of kindness, consideration, and common sense, professional etiquette can help you form new alliances and enhance established ones. Use these seven professional etiquette tips to polish your communication skills and strengthen you relationships with patients, families, and colleagues. Tip #1: Introduce yourself You wont feel awkward during introductions if youre always ready to introduce yourself. Dont just stand next to someone waiting to be introduced; take the initiative. Put out your hand for a handshake and say your name in a confident voice. Example: Hello, Im Margie McDermott, the new perioperative nurse educator. Be ready to introduce colleagues to others as well. Mention the name of the person youre making the introduction to first, then say the name of the person being introduced and say something about her. Then come back to the first person and say something about her.1 Example: Sharon, Id like to introduce Jack Brown. Jack is our new staff nurse with two years experience in the PACU. Jack, Sharon Jones has been our vice president of nursing since 2002. A good rule of thumb is to mention the higherranking person in the organization first. In the example above, the vice president (Sharon) is mentioned first and the new nurse (Jack) is introduced to her. Note that youre book-ending the introductions to include both people.
Tip #2: Have a confident handshake A strong handshake creates a positive first impression. Many people judge others by the quality of their handshake, so make sure its confident and firm (but not too firmdont overdo it). Stand up, lean forward, make eye contact, and smile. However, take into consideration cultural preferences and sensitivities that can impact a handshake. Example: In the Hindu culture, men dont shake hands with women.1 If someone ignores your attempt to shake hands, dont take it personally someone may avoid shaking hands because of arthritic pain. Gently drop your hand to your side and continue as if nothing happened. Tip #3: Keep conversations on track The ability to connect with colleagues and patients by making conversation is essential for success. To avoid inadvertently offending someone, stay away from controversial topics. Topics to avoid include religion, politics, salary, jokes of questionable taste, medical problems, and gossip. Topics that are usually safe to talk about include weather, traffic, sports, travel, books, and TV programs. When talking with a patient, remember that youre the caretaker. Dont discuss personal problems with a patient. If you have trouble getting a conversation started, try using the acronym OAR to help. Heres an example with a patient in a clinical setting. Observe. Make an observation. (It looks like youre ready for your surgery.) Ask questions. (Is this the first time youve been a patient in this hospital?) Reveal something about yourself, but avoid getting too personal. (After years of working in a large medical center, I like the friendly atmosphere of this community hospital.)1
www.ORNurseJournal.com
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OR Nurse 2010 March
Tip #4: Watch your body language Your body language is an essential component of communication. When making conversation, dont forget that the care you invest in your words can be undone by nonverbal communication. Example: Suppose while talking with a patient, youre slouching and not looking directly at him. Youre sending the message that youre not interested in what he has to say. Tune in and be aware of what image your body language is sending. Here are some body language tips to follow: Stand tall with your shoulders back and your chin up; avoid slouching. Keep your hands out of your pockets. Dont put your hands on your hips or cross them over your chest. Use a sincere smile to denote warmth and friendliness. Look at the eyes of the person youre talking with to show your interest. Dont wring your hands or make a fist.
Move with confidence and purpose. Dont drag or shuffle your feet. As a healthcare provider, you interact with patients and providers from diverse cultural backgrounds. Be sensitive to the fact that your body language could unknowingly offend someone; in some cultures, direct eye contact is considered aggressive. Your mistake may be obvious from someones comments, expression, or body language. Apologize immediately. If you dont know what you did, adopt a humble and respectful attitude and ask. Some gestures may be misunderstood and considered offensive to people from other cultures. To play it safe, try to avoid these in conversation: the okay sign thumbs up the V for victory sign, especially with the palm facing inward pointing or snapping your fingers waving your hand with your arm raised.1
TWO CLOSELY RELATED WORDS.
t is no surprise that patients respond favorably to warmed fluids and blankets. Warmed fluids and blankets maintain optimal body temperature, promote comfort, and help patients heal faster. Maintaining patient normothermia is a standard of care than can positively affect surgical outcomes and prevent postoperative complications. luid warmers from Enthermics precisely warm injection and irrigation fluids while blanket warmers keep blankets at clinically preferred temperatures. Individual or combination cabinets, with separate chambers for fluid and blanket warming, are available in a number of sizes. ENTHERMICS DELIVERS HEAT THAT SUPPORTS HEALTH.
Blanket & Irrigation/Injection Fluid Warmers 1.800.TO.B.Warm1.800.862.9276 www.enthermics.com ISO 13485:2003 Certified
March OR Nurse2010
15
New Nurse Notes
Tip #5: Cultivate a positive work environment The kindness, consideration, and common sense that characterize etiquette are also essential for nurse-tonurse collaboration. Be polite and courteous to your colleagues, no matter how stressful the situation. When you show respect for others and make others feel valued, you contribute to effective communication and team building. Example: Greet colleagues with a smile and a hello when you arrive at work, and say goodbye when you leave. Offer to help others, and thank others for helping you. Use good manners and polite language, and avoid listening to gossip or complaining with colleagues. Participate in department events to show your colleagues that youre a part of the team.1 The key is to keep your work environment positive. In July 2008, The Joint Commission issued a new sentinel event alert about behaviors that undermine a culture of safety.2 Disruptive behaviors include anything that interferes with the ability of others to effectively carry out their duties. Some examples include disrespectful language, demeaning behaviors, outbursts of anger, criticizing other caregivers in front of others, throwing objects (such as patient medical records), and comments that undermine a caregivers self-confidence in caring for patients. Besides being rude, these behaviors threaten patient safety.3 Tip #6: Dress for success Although informality is a trend in many workplaces, remember that the workplace isnt your home. It may not be completely fair, but people do judge you by the way you dress. What you wear supports or detracts from your professional image and sends a clear message to others about how you see yourself and how you want to be perceived by others. Most nurses would agree that they want to be viewed as professional, intelligent, and competent. You need to ask yourself if your appearance mirrors that image. If you dress too casually, patients may question your professionalism and attention to detail. Example: Does a nurse dressed in cartoon-print scrubs establish immediate trust, authority, and credibility? Cartoon prints may be appropriate for the pediatric surgical unit or the nursery, but nowhere else. Many patients complain that everyone in the clinical setting looks the same. This can be a safety issue if patients cant quickly identify a nurse in an emergency. Because patients and families want their nurses to be clearly identifiable, many hospitals are
re-evaluating their dress codes. A recent survey of 430 randomly selected adult patients found that 55% said it wasnt easy to identify their RN, 73% thought nurses should keep their hair back and off their shoulders, and 80% noted that theyd like to see a large RN on the nurses name badge.4 As a general guide, make sure your lab coat, scrubs, and shoes are clean and professional looking. Clothes shouldnt be too tight or scrub dresses too short. Of course, dont wear black underwear under scrubs. When your hair isn't covered by an OR cap and your hair is long, pull it up and out of your face. Other than when you are scrubbed in the OR, make certain your nametag is visible and readable. Tip #7: Present a positive, professional image Recently, I went to a medical center across town for an audiology consult. When I checked in, I was given a form to fill out and was told to wait until someone called my name. A woman dressed in white called my name and put out her hand. Thinking it was for a handshake, I put my hand out. However, she indicated that shed put her hand out for the form Id filled out. She directed me to another room, sat down, and started asking me questions. Because she never introduced herself and her nametag was turned over, I had to ask her to identify herself and describe her role in the organization. Because she ignored my handshake, she missed an important opportunity to introduce herself and present a positive professional image. Go aheadsweat the small stuff You may be familiar with the expression, dont sweat the small stuff. That advice doesnt apply to the clinical settingsweat the small stuff! Small things make a big difference. In fact, a recent editorial in The New England Journal of Medicine noted that good manners are at the heart of the mission of service-related professions and the finer points of patient care should be based on good manners.5 Many healthcare facilities are adopting policies to ensure more positive and professional interactions with patients. Here are some guidelines for professional encounters in all types of clinical settings. Address all patients as Mr., Mrs., or Ms. Use a first name or nickname only if the person gives your permission. Never use terms like honey or sweetie. Before going to meet the patient, take a few seconds to compose yourself and put a smile on your face.
16
OR Nurse 2010 March
Knock or speak softly, and wait for permission before approaching the patients bedside. Greet patients in a manner similar to the following: Welcome to ______(if this is your first patient encounter). My name is (first and last), and Im the registered nurse wholl be coordinating your care until (time). Review the patients plan of care. Explain to the patient what to expect preoperatively, intraoperatively, and postoperatively. Use open-ended questions. Ask the patient for input. When leaving the patients bedside, ask, Is there anything else you need? Make sure that important items such as the call bell are within the patients reach. When a patient thanks you, replace the phrase No problem with Youre welcome or My pleasure.1 Plan for success Exercising professional etiquette doesnt take a lot of time or effort, so make it part of your everyday
practice. Professional etiquette isnt optional for personal and professional success; its the critical link for coming across as a polished, confident, professional nurse. OR
REFERENCES 1. Pagana KD. The Nurses Etiquette Advantage: How Professional Etiquette Can Advance Your Nursing Career. Indianapolis, IN: Sigma Theta Tau International; 2008. 2 . The Joint Commission. Sentinel event alert: behaviors that undermine a culture of safely. http://www.jointcommission.org/Sentinel Events/SentinelEventAlert/sea_40.htm. 3. Porto G, Lauve R. Disruptive clinical behavior: a persistent threat to patient safety. Patient Safety Quality Healthcare. http://www.psqh. com/julaug06/disruptive.html. 4. Windle L, Halbert K, Dumont C, Tagnesi K, Johnson, K. An evidencebased approach to creating a new nursing dress code. Am Nurse Today. 2008;3(1):17-19. 5. Kahn M. Etiquette-based medicine. New Engl J Med. 2008;358(19): 1988-1989.
Kathleen Pagana is professor emeritus at Lycoming College and president of Pagana Keynotes & Presentations in Williamsport, Pa. Adapted from Pagana KD. 7 tips to improve your professional etiquette. Nursing Management. 2010;41(1):45-48.
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17
People Management Skills For New Supervisors and Managers-Twelve golden lessons.
By radharenu
People Management for New Supervisors and Managers.

Here, in this article I am going to share the twelve golden lessons on people management skills for new supervisors and managers that I learnt from my long experience of handling various types of workforce during my professional career in different industries. I have found these lessons indispensable for creating highly engaged workers and high-performance work units, which is a sure way of making of a truly successful business. The new supervisors and managers are initially seen to find it a little difficult to manage their employees at workplace. In a world in which managing people provides the differentiating advantage, it is my strong belief that every new supervisor and manager needs to learn these crucial lessons for managing his workforce effectively. Incidentally it may be mentioned that I have already explained in one of my other hubs on Employee motivation at workplace, how engaged workers are vital for enduring profits of a company. The points I have mentioned here regarding people management skills for supervisors and managers for are not specific to the nature of any industry but apply equally to any business. Some of the lessons may appear too basic and elementary but have great values when it comes to managing their workforce by supervisors and managers. I am more than confident that if some of these lessons are sincerely tried by the supervising managers and HR professionals in handling their workforce they would be surprised to see the positive results of their efforts in a very short period. It takes all sorts of people to make a world. Some people are selfish. Some people are good. Some people just dont bother at all. But this is what a good supervisor needs to realise. He mustnt expect perfect people all around. The managers and supervisors, who take into account all the different peculiarities of people, are the men with skills that are going to get results. The following twelve golden lessons on managing people have been found by me to be crucial to motivate, inspire and encourage the workforce at the shop-floor level and I am confident that these lessons would go a long way to greatly improve the people management skills of new supervisors and managers in any company. 1. No matter how good they have it people will always complain. Dont take it personally and let complaints upset you as it is human nature to complain. Play it cool and take it in your stride. Its part of your job as supervisor to deal with such matters; 2. No matter how trivial a grievance of a worker may appear to be to you, for goodness sake dont brush it aside. Consider all grievances patiently. Its well worth the time and the trouble; 3. Dont approach any employee with a proposal on a matter concerning him without first taking the trouble of seeing how it looks from his point of view, how will it affect his pride or what will his objections be. Its always best to sound people before taking any action directly affecting them; 4. Be careful when you talk to employees about their prospects and their future. They will remember every word you say and years later. It is easy to throw out promises, especially if you are in a good mood. But dont do it unless you are sure you can fulfil them. Otherwise, your reputation will stink; 5. When you are upset or irritated do not take any impulsive action so long you are in that mood. Wait till the next day and things will then look different; 6. We go out of our way to show courtesy to strangers but closer the people are to us the less we think of using the same to them. That is unfortunate because the courtesy which we give so freely to complete strangers is an excellent way of winning the cooperation and friendship of
those with whom we work every day. Therefore, an important lesson for a supervisor about people management is that it always pays to show similar courtesy as freely to the people who are close to him and with him every day; 7. Phrases like, Thank you, Would you mind, May I suggest, Perhaps you would consider, make all the difference between a friendly workplace where everyone works as a team, and a place where you have tension everywhere; 8. Another most important lesson on people management skills for new supervisors and managers is to try to make the jobs of their workers more interesting and give them change of work wherever possible to break their monotony. Otherwise, because of the dull routine nature of the jobs, there may be signs of behavioural problems even in case of the most active and intelligent workers. This also happens to the best among us under similar circumstances; 9. Dont push your workers around. However meek and quite they might appear to be, they are individuals just as we are and they all feel very fiercely about the things that concern them. Each of them has hopes and ambitions. They also aspire to own luxuries of life and become a boss. We should never treat them as a machine- as a chess piece, which can be played around with; 10. When dealing with your people, dont be tempted to contradict outright and tell them straight away that they are wrong. First show that you understand their point of view and stress the points on which you agree. Then you can gently tell them whats wrong. But if you contradict flatly, youll get into a time-taking and fruitless argument; 11. If someone comes with anger and in a confronting mood, the best thing to do is to disarm him first. May be a question about his family or cracking a joke about something-- anything except the subject on hand, may do the trick. He will then be in a mood to take any amount of persuasion and he wont bristle any more; 12. Teach the people with whom you work and always encourage for their development, which is very much one of your important jobs as a supervisor or manager; In conclusion I can say that every good company expects its supervisory managers to sincerely go through the above key lessons on people management skills for new supervisors and managers, which are considered crucial for proper development of the workforce with whom they work and there is certainly no better way for them for attracting the management's attention and getting promoted. Readers who would like this article may also like to read my other hub, How to avoid Common Management Mistakes of Supervisors at workplace
How To Be A Better Manager

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Guest Post: Eight Thoughts On Elegant Leadership

Posted on May 12th, 2010 by Keith Ferrazzi
Today's guest post is from two young authors whose insights on leadership are equally applicable for everyone from students to CEOs.
Eight Thoughts on Elegant Leadership By Evan Forster and David Thomas The fallacy that leaders must be perfect is one of the biggest misconceptions we encounter as educational consultants who have helped hundreds build outstanding candidacies to top colleges and graduate schools. Leadership development is a major component of our new book, The MBA
Reality Check . We came up with these eight insights about how to harness the leader in you.
1. Leaders think big -- and small. They have grand, visionary, ridiculous ideas. But they also return phone calls and show up on time. 2. Small acts of leadership create the potential for more leadership. Simply having an idea is an act of leadership, and its okay if you dont know where to go from there. For example, you want to create a green break room at the office. Go ahead and organize a meeting about the idea, even if you dont know the first step for researching the options or winning budget approval. That simple move is an act of leadership because the meeting creates an opportunity for others in the office to participate, come up with next steps, and even volunteer to share the work with you. 3. Management and leadership are not the same. Management is about a process, while leadership is about people. You manage deadlines, milestones, spreadsheets, work flows. You lead people, groups, attitudes, and relationships. Some excellent traits for good managementsuch as hyper-precision, detail-orientation, and staying the coursecan be harmful to good leadership. It is important to distinguish between the two. 4. Know your leadership style. Think of a typical group of friends who, when they go out as a group, tend to fill different roles: the organizer, the partier, the know-it-all, the charmer, the mediator. Which one are you? Knowing which role you tend to take in a group will help you understand and maximize the strengths and weaknesses that accompany that role. 5. Leaders arent afraid to make fools of themselves. For example, if you absolutely cant remember someones name, just be honest and ask that person again. And if you lack a certain skill set or dont have all of the information, its okay to say the following words: I dont know. Saying I dont know is powerful, because its confident, its honest, and it puts people at ease. 6. Real leaders dont cry. They dont have time for it. They dont blame other people. They take responsibility. If you havent ever really screwed up or failed, you arent really a great candidate for anything. Insightful, confident people often learn more concrete lessons from failure than from success, so dont deny yourself teachable moments by being afraid to act or pretending that your failures never happened.
http://www.keithferrazzi.com/leadership/guest-post-eight-thoughts-on-elegant-leadership/[11/21/2011 3:00:45 PM]
Eight Thoughts On Elegant Leadership Keith Ferrazzi
7. Leaders do not make excuses; they keep appointments and make deadlines. Leaders understand that everyones time matters. Leaders are not more important than teammates. This means if you make an agreement to be somewhere, you dont cancel at the last minute. 8. Leaders think in terms of legacynot their own, but their projects. This means creating new leaders from the very beginning. Great ideas shouldnt die when their founder leaves (or gets hit by a bus). I once heard that there are two kinds of mentors: those who are afraid their student will surpass them, and those who hope they do. Leadership is not about you, its about the impact you are out to achieve. If you keep that in mind, the idea of getting surpassed will bring you relief, not fear.
For more information on MBA admissions and The MBA Reality Check: Make the School You Want, Want You, visit www.theMBARealityCheck.com.
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Leadership Skills training for Lead LPNs

Created: November 2011 Revised:

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Program Evaluation Plan

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS STAKEHOLDERS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS PROGRAM EVALUATION RUBRIC

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Session 2: Professionalism and metric

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Session 3: Communication Strategies

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS Session 4: Leadership

Session 5: Best Practices Rubric

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Sessions Lesson plans

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Online follow-up session activities

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

SESSION 2: PROFESSIONALISM AND METRIC

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Online follow-up session activities

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

SESSION 3: COMMUNICATION STRATEGIES

Handouts and Additional Materials

Online follow-up session activities

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

Online follow-up session activities

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

SESSION 5: BEST PRACTICES RUBRIC

Online follow-up session activities

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

SESSION 6: REVIEW SERIES AND CONDUCT SELF AND SERIES EVALUATIONS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS LEADERSHIP SKILLS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS

LEADERSHIP SKILLS TRAINING FOR LEAD LPNS REQUIRED READING

LOUDER THAN WORDS

30 | T+D | NOVEMBER 2009

Photos by Shutterstock.com and iStockphoto.com

NOVEMBER 2009 | T+D | 31

Photos by Shutterstock.com and iStockphoto.com

NOVEMBER 2009 | T+D | 33

FEATURE ARTICLE Clinical Perspectives

Improving Employee Communication in the Clinical Setting

ABOUT THE AUTHOR

NOVEMBER 2002, VOL. 50, NO. 11

NOVEMBER 2002, VOL. 50, NO. 11

An Example of Service Recovery

Improving Employee Communication in the Clinical Setting

NOVEMBER 2002, VOL. 50, NO. 11

New Nurse Notes

7 tips to improve your professional etiquette

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