Marilyn Kelly RN MEd Lisa-Anne Hagerman RN Ed.D Heather Cross RN MN Paris Jalali RN MA

1. Practice & Education PartnershipsSupporting the Development of Nurturing Clinical Learning Environments for Students & New Graduates Marilyn Kelly RN MEd Lisa-Anne Hagerman RN Ed.D Heather Cross RN MN Paris Jalali RN MA

2. Funded by Ontario Nursing Secretariat, MOHLTC

3. Agenda • Theoretical Background • Leadership Development Program • Research Methods • Results • Conclusions

4. Theoretical Approaches

5. Leadership “…is a process ordinary people use when they are bringing forth the best from themselves and others. When the leader in everyone is liberated extraordinary things happen.” (Kouzes & Posner, 2007)

6. Five Practices of Exemplary Leadership • Model the Way • Inspire a Shared Vision • Challenge the Process • Enable other to Act • Encourage the Heart Kouzes & Posner, 2007

7. Nurses at the bedside contribute to inviting clinical environments in which students and new graduates feel welcomed & accepted, and challenged in ways that help them grow Thomka, 2007

8. Invitational Theory (Purkey & Aspy, 2003) Based on four basic assumptions about people: • Trust • Respect • Optimism • Intentionality

9. Program Design • 24 Emerging Nurse Leaders • 24 Mentors • 8 health care organizations within the LHIN

10. Emerging Nurse Leaders Engaged in • 3 six hour leadership workshops at Conestoga College • A short term leadership project • A time limited mentorship relationship

11. Mentors • Workshops • Supported project • Provided mentorship through meetings with new leaders

12. Aim of Study • investigate whether an emerging nurse leader development program created a change in leadership practices • uncover the experiences of program participation

13. Research Methods Purposive sampling strategy was used to recruit 48 nurses Measures • Demographic information • Learning Practices Inventory (Kouzes & Posner, 2003) • Nursing Retention Index (Cowen, 2002) • Focus groups

14. 98% female 94% RNs 6% RPNs 57% diploma 30% undergrad degree 13% graduate degree Demographics 65% full-time 35% part-time or casual

15. Leadership Practices InventoryEmerging Nurse Leaders

16. Leadership Practices InventoryMentors

18. Emerging Nurse Leader Themes • Acquired Leadership Knowledge • Empowered to Make a Difference (Self Awareness) • Learning from Their Mentor

19. Acquired Leadership Knowledge “I found I learned a lot about myself, a lot about my own leadership. I think that was the part that was missing”

20. Empowered to Make a Difference • “ I think ..what I got …(is that).. you have to start the changes yourself” • “..given me the courage to be involved in improving the work environment”

21. Learning From Their Mentor “My mentor was wonderful because she would provide me with a lot of background...[and] what we could do about it.”

22. MentorDevelopment of Self as Leader “This program has just made me realize that...I do have a lot of ways to show my leadership skills...and it’s helped me advance in a way”

23. “I just enjoy it…..I enjoy sharing my knowledge and experience and my leadership skills with my colleagues.”

24. Successes • Completed projects, including ones that enhanced unit processes • Individual empowerment and greater sense of control over the work environment • Enhanced leadership behaviours • Succession planning

25. Completed Projects • Medication reconciliation in the ER • Communication tool for transfer of care between units • Generation gap between nurses • Implementing responsibilities of night shift • Orientation guide to pacemaker clinic

26. Limitations • Small sample size for quantitative measures • Participants self-selected • Self-assessed leadership behaviours, immediately after program participation

27. Recommendations & Future Steps • Concurrent investment in leadership & mentorship development • Financial investment is essential • Does leadership development in point of care nurses impact the clinical learning environment for students?

28. Conclusion • A leadership development program that combines project experience, workshops & mentorship may impact leadership behaviours in mid-career point of care nurses • Engage nurses at their moment of “readiness to learn”.

29. References Cowin, L. (2002). The effects of nurses’ job satisfaction on retention: an Australian perspective. Journal of Nursing Administration, 32 (5), 283-291. Cowin, L.S., & Hengstberger-Sims, C. (2006). New graduate self-concept and retention: a longitudinal survey. International Journal of Nursing Studies, 43 (1), 59-70. Kouzes, J., & Posner, B. (2003). Leadership Practices Inventory: psychometric properties. San Francisco,CA: Pfeiffer Kouzes, J., & Posnter, B. (2007). The leadership challenge (4th ed.). San Francisco: John Wiley & Sons. Purkey, W., & Aspy, D. (2003). Overcoming tough challenges: An invitational theory of practice for human psychology. Journal of Humanistic Psychology, 43 (3) 146-155. Thomka, L. A. (2007). Mentoring and its impact on intellectual capital: Through the eyes of the mentee. Nurse Administration Quarterly, 31 (1) 22-26.

30. Nursing Retention Index • It is my intention to continue with my nursing career in the near future • I would like to stay in nursing as long as possible • As soon as it is convenient for me I plan to leave the nursing profession • I expect I will keep working as a nurse • My plan is to remain with my nursing career as long as I am able • I would like to find other employment by leaving nursing (Cowin, 2002)