Leader to Watch Ramón Lavandero, RN, MA, MSN, FAAN

Transcription

1 Leader to Watch Ramón Lavandero, RN, MA, MSN, FAAN Linda Burnes Bolton, DrPH, RN, FAAN R amón Lavandero, RN, MA, MSN, FAAN, is senior director of the American Association of Critical-Care Nurses (AACN) and clinical associate professor at Yale School of Nursing. A native of San Juan, Puerto Rico, he has held clinical, management, and faculty positions at medical centers and academic institutions in the Northeast and Midwest United States. As founding director of the International Leadership Institute at the Honor Society of Nursing, Sigma Theta Tau International, he has consulted on nursing and health care in the Caribbean, Europe, and North and South America. Lavandero has served AACN in volunteer and staff leadership roles since the 1980s, including the team that developed AACN s Standards for Establishing and Sustaining Healthy Work Environments. LBB: Why nursing? Especially since fewer than 1 in 10 nurses are men. RL: Won t it be great when that question doesn t get associated with gender! But it s entirely fair to point out every nurse s obligation to address nursing s dramatic gender and ethnic-racial disparities. You and I have seen incremental advances during our careers but not of a magnitude that mirrors our country s general population. LBB: Each of us has faced challenges while we try to make our optimal contribution to society and the profession. What challenges have you faced as a Latino man who is a nurse? RL: I m saddened when I hear of challenges, sometimes outright intolerance and bigotry, that many of our colleagues continue to face because of their gender or ethnic-racial background. There are so many success stories, especially when a person views the tapestry that is each nurse s career, instead of its isolated threads. I m either oblivious or blessed, maybe some of each. LBB: Do you mean you haven t encountered challenges? RL: Sure I have. Haven t we all? But I don t think it s about rehashing challenges. I think the real question is why a given situation challenges 1 nurse while a colleague sails right through unimpeded. Haven t you run into that? LBB: I have. Why do you think that happens? RL: I think it s because we miss the point. Latino man isn t the issue, nor is African American woman or Caucasian person regardless of sex. Each of us is a talented individual with unique knowledge, skills, and abilities. We re stronger in some areas and works-inprogress in others, so we re challenged when we re caught off guard and ill equipped to handle a situation. It s the reason you ve been successful in situations where other African American women have run into difficulties. And you ve been challenged where others haven t. I ve had the same experience. LBB: Can you give an example? RL: Take women s health. Countless male colleagues have described emasculating student experiences that are unworthy and embarrassing to our profession. I was one of Columbia 15

2 University School of Nursing s first 2 male graduates. My women s health and perinatal experiences were so reaffirming that I worked in the delivery room and postpartum for a year and seriously considered becoming a midwife. Kathy Douglas profiled a male nurse midwife in her extraordinary film, Nurses: If Florence Could See Us Now. He wouldn t have been successful if being a man got in the way. LBB: Being 1 of Columbia s first 2 male graduates is quite an honor. Are there other honors that have been meaningful? RL: Some have been professionally meaningful, some personally. Graduating from Columbia when I did was meaningful for men in nursing because it was a high profile nursing program that hadn t graduated a man in its 75-year history. LBB: So back to my earlier question, why nursing? RL: My grandfather was a physician, so it was assumed I would follow in his footsteps. Let s face it: nursing wouldn t have even registered on the career scale 16 for a Puerto Rican physician s first grandson, not even for a granddaughter. Ironically, my grandfather died when I was very young, and I had little contact with medicine as a career. LBB: Where did nursing come into play? Did someone suggest it to you as a career? RL: A lifelong family friend, a Puerto Rican physician educated in the US, suggested I seriously consider nursing and set me on the path that led to Columbia and then Yale. My contact with nursing began with a master sprepared Catholic nursing sister when I did community service as a student in a Jesuit prep school. It continued as an emergency room volunteer, during a seminary rotation in a hospital for advanced cancer patients, and as an emergency and critical care technician in college. Nurses were always welcoming, encouraging, and eager to teach me. LBB: Have you received an honor that was personally meaningful? RL: I was recently named 1 of Yale School of Nursing s 90 Nurses for 90 Years, a group selected for truly repre- senting and modeling for future nurses what the school stands for. It s a profound and unexpected honor, given the breathtaking array of contributions Yale alumni have made to nursing since LBB: Is that the only honor? RL: In 2005 I received the Victoria Champion Boundary Spanning Award from Indiana University (IU) School of Nursing. It had great meaning for me because my admiration for Vicki Champion s interdisciplinary accomplishments at IU validated for me that it was alright not to be pigeonholed into a narrow slot within nursing. LBB: So you re not a fan of expertise that s focused and well-honed in a particular area? RL: I am, just like I m a fan of expertise and experience that span the waterfront. Nursing is made so much stronger when a wide range of possibilities becomes acceptable and individuals are nurtured to play to their strengths. It took me much longer than it should have to understand this and to find leaders who value it. It s our obligation as leaders to help colleagues October 2013

3 identify their strengths and coach them, no matter where they are on their career journey. LBB: Reflecting on your leadership journey, what are some pitfalls you ve stepped in? RL: Academic preparation was a big 1. My first graduate degree was in adult education. Its learner-focused content and approach have been invaluable; I just did it for the wrong reason. New York City had excellent graduate school options for nurses at the time, but the options were limited and, naively, I didn t want to attend 1 of the same schools as everyone else. When I realized I d also need a graduate nursing degree to achieve some of my goals, I followed my passion toward a clinical master s degree instead of diving into a doctorate. I never made the time to study after that. LBB: Are there things in your career that have happened exactly as you planned? RL: Ha! Not really. Sometimes to my detriment, I ve often resisted calculated career plans. The best plan I could muster after nursing school read something like: Prepare myself with the right credentials and experience so I can hold clinical and/or management and/or academic positions, separately or concurrently. Looking back, though, I think it suited my temperament and prepared me for unforeseen opportunities. LBB: Such as? RL: You could probably say that much of my career is a patchwork of unforeseen opportunities. Working with and for a professional association may be the most notable of those. My undergraduate education primed me well to become an active association member, but I was ignorant about working for associations. AACN and Sigma Theta Tau opened the door to a world where I ve spent half of my career so far. LBB: How would you advise nurse leaders who want to strengthen inclusivity and diversity in nursing? RL: It s all about what you bring to the table and how you put it forward. This isn t unique to inclusivity and diversity, you know; it s not even unique to nursing. I had the opportunity of participating in the development of AACN s Standards for Establishing and Sustaining Healthy Work Environments. In 2005, it was a landmark document that preceded most health care organizations in calling out the positive impact of certain factors on patient outcomes and job satisfaction. LBB: What were those factors? RL: There are 6 of them: skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. The standards posted at are a quick read. They describe these factors and include critical elements. LBB: How do these factors of a healthy work environment relate to strengthening inclusivity and diversity in nursing? RL: I think they relate directly because they re universal and fundamental for effective human interaction. After all, aren t we people who happen to be nurses, not nurses who happen to be people? If a leader becomes knowledgeable about inclusivity and diversity, without mastering the healthy work environment skills, she or he is likely to fall flat and even cause unintentional damage. 17

4 Hometown: San Juan, Puerto Rico Current job: Senior director, American Association of Critical-Care Nurses, and clinical associate professor, Yale University School of Nursing Education: BS, Columbia University School of Nursing, MA, Teachers College, Columbia University, and MSN, Yale University First job in nursing: Clinic assistant, Dispensario Nuestra Señora de la Providencia, San Juan, Puerto Rico Best advice for aspiring nurse leaders: Find honest and skilled mentors to guide and mirror your journey Most people don t know that: Living and studying in Cleveland, Ohio, for grade 11 was one of the most transformative years of my life One thing I want to learn: The secret to finding balance One word to describe me: Passionately intense LBB: How do we engage nurses in a celebration of diversity? RL: Isn t the need for diversity related to the search for truth? Eric Law 1 from the Kaleidoscope Institute wrote a thoughtful piece about discerning truth in a diverse and changing world. In it he talks about the world s dominant true/false, either/or paradigm. Law suggests that in order for a community to discern the truth, it needs to take into account the different perspectives even when they seem to be opposite or contrary to each other. It means to me that we can celebrate diversity only when we embrace its value. LBB: Nursing care for a global community within and outside the US borders is work that our nurse leaders will need to prepare themselves to embrace. How can the American Organization of Nurse Executives (AONE) support this? RL: For more than 15 years, first as a nurse executive then as AONE s chief executive officer, Pam Thompson has nurtured impressive ties with nurse leaders in other countries, initially in Eastern Europe and the former Soviet Union. That s a terrific foundation from which to expand, given that so many AONE leaders have current links to other parts of the globe. It ll enhance AONE s learning and support development of a thoughtful and cohesive outreach for nursing care of a global community. LBB: How else can an individual AONE member such as me fit in? RL: Initially it s about learning and helping others learn. Skilled members can coach their colleagues who are eager to learn. Start with the basics, if that s where you are. The US focus on a melded population has enabled extraordinary successes on many fronts. Culturally, it puts us a bit behind other countries where multiple language skills and global awareness are pretty much expected. A quick trip across the 49th parallel will confirm that our Canadian friends live in a bilingual nation and know much more about our country than we do about theirs. LBB: Any suggestions on how to jumpstart the learning? RL: Here are 2 that you can do in tandem. It s naïve to assume we don t need additional language skills because everyone else understands English. Many of them do. They also speak several other languages. Expanded language skills mean expanded cognitive skills, even for adults. Strengthen those kills with a second or third language. And do it for fun, not necessarily because it s the right language. You can do that 1 later. LBB: What s the other 1? RL: Learn how others see us and our issues. It s also easy and fun if you start with regular visits to and The first site reflects global opinion about the US to help readers understand what the world thinks of current issues that involve the US. The site posts news and views about the US published in other countries. The second site links to newspapers of the world. See what makes the headlines on a given day and compare it with American newspapers. Also look specifically for healthrelated news. You ll recognize this approach if you ve been to the Newseum in Washington, DC, where an exhibit does similar front page comparisons among US newspapers. As 18 October 2013

5 you amp up your language skills, start looking at newspapers in that language. All of these activities help us meet others on their playing field, instead of expecting they ll come to ours. LBB: Any thoughts about AONE s work within the international community? RL: I d suggest AONE s first obligation is to embrace the humility of learning from our international colleagues. Consulting internationally, I was often told I had been invited to share what were seen as the dazzling successes of the American experience. I soon learned several lessons that served me well. First, that it s human nature to be more open to learning when the learner genuinely feels the teacher is also learning. Second, you need to find out the backstory. Every success has one, and it s often glossed over. Third, success is contextual and not automatically exportable, even among institutions in our own country. LBB: What are your aspirations as a nurse leader? Where do you see yourself in the next handful of years? RL: The magic of leadership is that it s not about someone s title; it s about how he or she influences. AACN is at the cusp of a significant leadership transition, which makes it an exciting time for every leader across our professional community. If I ve been at all successful in influencing individuals and organizations, I aspire to continue doing so. Where I haven t succeeded, I want to learn how to do it more effectively. LBB: What are your words of wisdom for nurses on their leadership journey? RL: In a metaphor, learn how to focus while surveying the landscape and vice versa. We tend to be more comfortable with 1 over the other, but it s most useful when we become adept at both. Seek out people who are good at each and those who artfully blend both. That way it will become second nature to stop and smell the flowers while you notice the squirrel hovering on the periphery and the jaw-dropping view that s just ahead. These aren t skills that are uniquely for nursing. They come in handy all across life. NL Reference Law E. Discerning the truth in a diverse and changing world. Weavings. 2013;28(3):31. Linda Burnes Bolton, DrPH, RN, FAAN, is the vice president and chief nursing officer of Cedars-Sinai Medical Center in Los Angeles, California, and can be reached at bolton@cshs.org. Photography by David Fox /2013/ $ See front matter Copyright 2013 by Mosby Inc. All rights reserved