For Dr. Colleen Swartz, chief nurse executive

Transcription

1 Leader to Watch Colleen H. Swartz, DNP, MSN, MBA, RN, NEA-BC Diana J. Weaver, PhD, RN, FAAN For Dr. Colleen Swartz, chief nurse executive of UK HealthCare (UKHC), success is achieved by providing patient- and family-centered care through the combined and coordinated efforts of the entire team. Dr. Swartz is certainly a strong proponent of the essential value of nursing, but her experience and expertise have taught her that it s all about the team in today s complex and sometimes chaotic health care environment. And nursing leadership plays a pivotal role in making teamwork a reality. My role and, in turn, what I hope is my legacy, is to enable the entire team to find a path to patient and family as the center of our collective knowledge and interventions. At times, that is very difficult, and not always evident in light of the swirling complexity and multiple, sometimes conflicting, messages that bombard the caregiver at the bedside. Dr. Swartz has a solid history of working closely and productively with other clinical disciplines. She began her leadership career as the coordinator for the trauma service, the chief flight nurse in the air transport program, and as director of trauma and emergency services. She then left UKHC for a stint as the chief nursing officer (CNO) in a neighboring regional hospital. She returned to assume the leadership of the capacity command center, which handles patient placement and throughput for the entire system. In each of these roles, she noted the importance of clinical coordination of each of the involved disciplines. When this was absent, patients fell through the cracks, the opportunity for errors increased, and outcomes were compromised; thus, her resolve and her commitment to the importance of teamwork with a common, well-communicated plan of care for the patient. DJW: What made you choose nursing as a career? CHS: Frankly, I did not have a lot of choices from a financial perspective. My oldest sister is a nurse, as is my husband s. My sister was successful in her career choice, and as I heard her talk about her work, I thought, I could do that. For me, it was not a calling, rather a pragmatic decision. But it has certainly been a rewarding one and the right one. DJW: You mentioned your sister; I have heard you talk about your family, and I know you are the youngest of five girls, all of whom are high achievers. What influences in your childhood shaped you as a nurse leader? CHS: I grew up in what at that time was a traditional family. My father Nurse Leader 241

2 worked outside the home, and my mother was a full time homemaker in fact, she did not drive until she was 37 years old. Neither of my parents completed high school, but the value of academics was always stressed. Every week, my sisters and I were taken to the local library to check out books. In high school, I played several sports, was a member of the debate team, and was very involved. But there was never any question in my house, our studies came first. The implied message was that each of us needed to be able to take care of ourselves. Through my sister, I internalized the value of giving back. DJW: What would you describe as your greatest success as a nurse leader? CHS: I don t know that I would characterize as success, but it was certainly significant in its impact on me as a leader. In 1999, we lost our entire team in a tragic helicopter accident. As the leader, I realized how important my role was in helping the team get through this devastating circumstance. I needed to be there for each member of the team and for the entire team, while recognizing that 242 Nurse Leader the needs of each were very different. I was present throughout the first 48 hours, one of the first onsite, and certainly the last to leave. That was a time of intense learning for me, as I internalized the significance of leadership during crises. DJW: I have heard you refer to that incident on many occasions, so I know it left an indelible mark on you as a leader. All leaders face challenges, some of which at the time, appear insurmountable. Describe a time in your leadership career, when you thought failure was a real possibility. CHS: In fact, failure was a reality. It happened in 2010 when we lost our Magnet designation. I gained so much learning from this failure. It was very motivational and, for me, served as a call to action. I believe most leaders recognize that importance of being able to lead through failure, using the lessons learned to improve, get stronger, if you will. And that message must be passed on to those whom you lead. Failure is a reality for all of us. What we do with it, in large measure, defines us as leaders. DJW: This issue of Nurse Leader is focused on mentoring and coaching. What opportunities have you had to actively coach and mentor in your current role? CHS: Completing the Robert Wood Johnson Foundation Executive Nurse Fellows Program helped me frame a structure and seek avenues for mentoring as an important aspect of my leadership function. In order to be effective at coaching, one must be open, reflective, and available. And for busy leaders, that last one can be the most challenging. I believe I must be available to a variety of audiences students, new employees, current staff, and certainly my leadership team. As you know, I have offered to spend time with any nursing staff member who requests that. I have found that my shadowing experience provides first-hand opportunities to not only coach in real time, but to gain current information regarding what is and is not working well for the staff at the bedside. Those experiences are also invaluable in allowing me to step back and get a sense of patterns in the work environment that either support or create barriers to August 2016

3 patient-centered care. And the more I do this, the greater receptivity and mutual regard I have found in others with whom I interact across the organization. DJW: Just as you have mentored others, who has served in that role for you? CHS: There have been several over my career. Early on, the CNO here took a chance on me as she saw leadership potential in me that I had not realized I had. That opportunity helped me to begin thinking about myself as a leader. When Dr. Karen Sexton assumed the CNO role, she nurtured that leadership spark in a number of ways. I learned the specifics about one of these, only recently. In 1999, Karen approached me about pursuing an MBA at the Gatton School at UK. Other leaders in the organization were taking advantage of the recently formed partnership between the hospital and the business school, but no nurses were in that number. Dr. Sexton encouraged me to go for it and I did. About 2 years ago, she told me that she was looking for a way channel my energy and keep me challenged as an emerging nurse leader. That was a wonderful plan, and my MBA has allowed me to be a contributing partner at a number of tables. In fact, all of my education has done that, but I am so grateful that Karen pushed me out of my comfort zone. One of the challenges of mentoring rising stars is honing the ability to keep them stretching for new goals that allows them to grow and add value to the organization they serve. Mentors open doors and prompt possibility thinking. DJW: What equipping advice would you offer to novice nurse leaders? CHS: Engage in honest self-assessment. And once is not enough. Self-reflection and self-awareness must be an ongoing process for nurse leaders throughout their careers. An essential piece of the process is identifying the gaps in one s repertoire of leadership skills, then developing a plan to address them. The goal is mastery. That can be addressed through self-development as well as in complementary partnerships with others. The strongest nurse leaders I know have honed this process and engage in it on a daily basis. It is truly an expression of humility that is foundational in leadership. DJW: What do you consider the top 5 attributes that a nurse leader must possess in today s health care environment? CHS: The first is closely aligned with my answer to the last question; that is giving and receiving feedback. As leaders, we understand the need to give feedback, but often do not give due diligence to receiving it, which is so critical to our ability to astutely lead. It is imperative to hard-wire feedback processes into all that we do. There is an art to giving and receiving feedback and the foundation is a relationship built on trust trust that the purpose of the exchange is to be helpful and constructive, even if the message is difficult to send and receive. Finally, there must be intentional framing so that both parties understand the purpose of the conversation. I have been fortunate to have a variety of sources for feedback. Through the RWJ program, I was provided an external coach. Having someone to whom I could speak without fear of judgement or reprisals was so helpful and allowed me to receive critical feedback in a safe exchange. That experience tempered my reaction to feedback from others, and I believe I now actively and openly seek feedback to help me see myself with situational and context clarity. That clarity allows Nurse Leader 243

4 Name: Colleen Hope Swartz Hometown: Waynesville, Ohio Current job: Chief nurse executive, UK HealthCare, Lexington, Kentucky Education: ADN, Morehead University; BSN, University of Kentucky; MSN, University of Cincinnati; MBA, University of Kentucky; DNP, University of Kentucky First job in nursing: Staff nurse on a gyn-oncology unit Most people don t know that I: Love college football. My favorite team is the Ohio State University Buckeyes. One thing I want to learn is: Yoga One word to describe me: Tenacious Being in a leadership position gives me the opportunity to: Give back My best advice to aspiring nurse leaders: Remain hope-filled and optimistic me to reflect on, adapt, and hopefully improve my leadership abilities. Next is leading through difficult change. Leaders have always been expected to do that, but today the stakes seem higher. Think about the shifts we have seen in health care over the last 10 years or so. All the key variables the payer systems, models of care delivery, to name 2 are in a state of flux. It is little wonder that those whom we lead often feel as if there are no constants. In many situations, it is the leadership which serves as the grounding factor. Third is boundary spanning. Embracing and valuing an interdisciplinary approach to leading is vital in today s environment. It may have always been, but given the complexity of the environment in which we are immersed, that can be no question that exemplary nurse leaders must look beyond the delivery of nursing care and engage with others to develop best approaches and solutions to provide excellence in all we do. Everyone wins when this is the accepted approach for patients. The fourth attribute is closely tied to the third, and that is leading teams. In the past, the organizational hierarchy defined the leadership approach for all leaders including nurse leaders. Issues to be managed in today s organizations demand that all stakeholders be at the table and nurse leaders must not only be able to lead these diverse groups, they must be able to identify the essential voices and orchestrate the team s goal attainment. Finally, nurse leaders must be able lead in a partnership model. Our organization is developed along service lines, which means that each nurse leader, from the unit nurse manager up to and including myself, has at least 1 and often several partners who make up the leadership function. Certainly physicians are included in that partnership, as well as administrative and financial colleagues. Effective nurse leaders do not fly solo or lead in a vacuum. DJW: What do you consider to be the most frequent mistake or career de-railer that aspiring nurse leaders can make during their careers? CHS: The one I see most frequently, especially in novice leaders, is thinking that they need to be friends with those whom they lead. The transition from peer or coworker to leader is especially difficult when the leader is promoted from within the work unit. And, I don t want to infer that only new leaders struggle with this. As leaders, each of us has found ourselves in situations where we had to clarify the boundaries between our role as leader and that of colleague. I don t know that we do as much as we can and should to assist our new leaders through this transition. The desired professional dynamic is respect with reciprocity, but that is easier to talk about than to put into action for some. DJW: Along that same line, leadership can be lonely. How do you cope with that reality? CHS: Yes, it can get lonely, especially during times of stress or change. I have learned that I must be more intentional about how and from whom I seek validation. That means I must separate my roles and pay just as much attention to who I am away from the job as I do in to activities and responsibilities here at work. There is more to me than serving as the CNO 244 Nurse Leader August 2016

5 of UKHC. I am a wife, a mother, a daughter, a citizen who wants to give back, and each of these roles are important to me. Therefore, I have found it is necessary to invest time and energy in the roles in order to keep my sense of balance and well-being. I have also learned to seek the advice and counsel of trusted colleagues and friends when I am feeling vulnerable or a bit off-kilter. I have been fortunate to have individuals who are always available to me. And I try to reciprocate when they need a listening ear. Most leaders I know are gracious, empathetic, and nonjudgmental. They have walked that same lonely path at times during their career. DJW: What do you want for your legacy in nursing? CHS: Simply put, that patient- and family-centered care was always at the center of everything I do as a leader. And that my words and actions provided the essential support to whose whom I led so that collectively, we were able to make patient-centered care a reality for all we served. Our nursing motto at UKHC, Every patient, every time, is very personal to me, and I hope I have been able to impart that as a grounding principle for all of those whom I have had the privilege to lead. Finally, never losing sight of the reality that leading is both a privilege and a responsibility one that can never be taken lightly or for granted. NL Diana J. Weaver, PhD, RN, FAAN, is senior nursing advisor at UK HealthCare in Lexington, Kentucky. She can be reached at dweav2@ .uky.edu /2016/ $ See front matter Copyright 2016 by Elsevier Inc. All rights reserved. Nurse Leader 245