Many nurse managers today, in addition to operational responsibilities, are accountable for promoting collaborative practice, demonstrating evidence-based practice, and incorporating research into their practice settings. To complicate things further, staffing is increasingly problematic and managers must now hire unregulated support staff to meet clinical demands. This situation adds a new layer of complexity to workplace relationships and work distribution. In this environment, it makes sense for nurse managers to create a solid plan, similar to a business plan, for mapping and creating their clinical future and how they will accomplish the work. Foundational to creating a clinical community of excellence is a clear statement of the practice setting’s mission, vision, and values; promotion of trust; and an unshakeable belief about how everyone will work together. When these are present, staff thrives! A challenge, yes; impossible, no. Developing a back-to-basics action plan unifies staff and signifies strong nurse manager leadership. This chapter sounds an urgent call and provides a suggested path for nurse managers to do just that! In this chapter, you will learn: 1. The importance of developing your practice setting’s mission, vision, and values 2. The process for promoting trust and creating a team charter 3. The necessity of developing a back-to-basics plan as a step toward creating your future. Peter Drucker, an influential leader in management theory and practice, once said, “The best way to predict the future is to create it.” What kind of workplace future do you want? What does staff want? These questions are normally not asked or answered by nurse managers and their staff. Instead, managers default to the organizational culture’s formal statements about “our mission, vision, and values,” which are typically generated by senior management during a strategic planning retreat. Typically, nurse managers are expected to disseminate and discuss the organizational mission, vision, and value statements to secure buy-in to the future direction of the organization. Staff members respond, in turn, with cynical and tacit approval without ever truly owning the words or their intended message. The reason is that most staff has witnessed countless violations of newly minted organizational mission, vision, and values statements, stemming from no real plan as to how staff members will achieve these expectations. The stories of leaders “not walking the talk” are legendary. Too often, staff members experience fear in the workplace or are treated badly in organizations that simultaneously claim “people are our greatest assets.” They become disillusioned with these “organizational truths” and the mission vision, and values become meaningless. FAST FACTS in a NUTSHELL • Most staff members have a vague recollection that somewhere in their organization is a laminated plaque depicting the organizational mission, vision, and values statements. (It is usually doomed to suffer a lonely existence hanging between the elevators for everyone to see without really seeing.) Fundamentally, most staff want and need to participate in meaningful work, contribute to the greater good, and know that they matter and make a difference in the lives of others. When this happens, they are motivated to provide better care, achieve personal and professional success, and experience work life satisfaction. When units develop their own practice setting, mission, vision, and values that complement the larger organization’s M, V, and V, they lay the foundation for creating their future. In the end, they feel a sense of ownership in the quality patient care outcomes and work life. Especially during times of change, it is important for nurse managers to help staff reconnect to the meaning of their work and to the overall purpose of the organization. It is very easy for staff to feel disconnected at this time, to “go rogue,” or do their own thing because “we’ve always done it this way.” • Creating your practice setting’s mission, vision, and values statements provide staff with a sense of direction, create context for the type of care/service delivered, and reinforce the moral and ethical drivers that guide the decisions and actions of the health care team. • A mission describes the purpose of a clinical program or service and aligns staff on a shared journey. • A vision reflects, “. . . our hopes for a preferred future” (Oakley & Krug, 1994, p. 227). • Values represent the ethical and moral standards that will guide professional care and relationships in a practice setting. 1. Create opportunities to promote reflection and dialogue that provide staff with an opportunity to create their vision of how the members see themselves and the role they play in service delivery. Try asking the following questions, record the discussion, and use the answers in planning your vision statement. • Why do we exist as a practice setting? What is our shared purpose in the provision of health care service delivery? Why are we different? • Why is this service essential to overall organizational success? What business are we in? (Do not accept answers such as, “Because we care for mothers and children” or “Because we care for surgical patients.”) • What special roles do our various team members play in the provision of care? 2. Reflect on and discuss the professional attributes and scopes of practice within all staff groups (nurses, care assistants, technicians, etc.). 3. Engage staff in the “Postcard from Home” exercise (see Appendix). 4. Conduct a values development exercise (see “Creating Our Values” in the Appendix). 5. Have a conversation about “Living Our Values” (see Appendix). 6. Have fun with the “Back to Our Future” exercise (see Appendix). 7. Use the “Back to the Future Follow-up Conversation Guide” to help staff identify specific suggestions for improving quality of work life or strengthening workplace relationships (see Appendix). 8. Review your mission, vision, and values annually to assess their effectiveness and determine whether they require modification. Trust building is the relational glue for effective interpersonal relationships. It determines how well staff members work together. Nurses know how to build and maintain trust within the context of the professional and therapeutic relationship to achieve successful patient/client care outcomes. Trust is equally important to team functioning. In many of today’s chaotic and changing workplaces, trust at an interpersonal and organizational level is at an all-time low. Without trust in the manager, the practice setting metaphorically becomes a rudderless ship. Leaders require followers. Without trust in staff members and their abilities, nurse managers cannot effectively lead. Trust is a complex and multilevel attribute. It encompasses integrity, honesty, transparency, and accountability, the essence of which is captured in nursing’s standards of professional practice.
Creating Your Future
A Back-to-Basics Approach
PREDICT YOUR WORKPLACE FUTURE: BEGIN BY CREATING YOUR MISSION, VISION, AND VALUES
WHEN STAFF LOOK BUT DO NOT SEE
WHAT WE WANT—WHAT WE REALLY, REALLY WANT
CREATING YOUR PRACTICE SETTINGS MISSION, VISION, AND VALUES
FAST FACTS in a NUTSHELL
WHERE TO START
BUILD TRUST AND THEY WILL COME
TRUST IN THE WORKPLACE
FAST FACTS in a NUTSHELL
Nurse Key
Fastest Nurse Insight Engine
