Overall Format of Leadership Training: Interested and Very Interested

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North Dakota Action Coalition Targeted Leadership Training Survey Results October, 2013 1. Overall Format of Leadership Training: Would you be interested in additional leadership training provided as: Overall Format of Leadership Training: Interested and Very Interested Online format with option to obtain CE for fee 68% Connection with Mentor 52% large audience like Summit 65% face to face topic specific 54% online format webinars 68% 0% 10% 20% 30% 40% 50% 60% 70% 80% I would love to get more nursing related training in managing or supervising. I was just promoted to a supervisory position and lost it as I was floundering in knowing how to handle supervising I am an LPN so that was not anything we covered in school. I am nearing the end of my career and have been fortunate to have had extensive leadership training and opportunities to serve. Student involvement desired for students in the Leadership class. I practiced in Los Angeles, California as an CNS in Adult Health. Moved out here when I became a CNS and was told there were no CNS positions available in ND. HAVE RUN INTO FABULOUS OPPORTUNITIES OUT HERE. SO GLAD I CAME. Planning retirement soon Don't know about the connection with a mentor

2. The Systems Thinking group is working on designing leadership training in this area. They have defined a system as a "set of objects or elements in interaction to achieve a specific goal" and that the NURSE is in a unique position to put all pieces of the System together. Would you like to learn more about: Systems Thinking Interested and Very Interested the variety of payer types such as private insurance, Medicare and Medicaid and uncompensated care and the qualifications and requirements for eligibility for each level of payer the outside forces that have shaped and will shape the healthcare industry 68% 72% the variety of facility and provider types in your community and how your employer and physicians relate to them 55% organizational structure of your employing agency 40% Organizational structure of the nursing department in your current work environment 42% Operational systems you work with each day 44% 0% 10% 20% 30% 40% 50% 60% 70% 80% Nurses are really in need of knowing what happens with a family post facility! For some---they are in a 'black hole'. What is support to caregiver? What do Faith Community Nurses do and how can they help prevent readmissions? Home health the same. Who pays for rehab for elderly, how many days, etc. Nursing roles in state government require systems thinking; however, the topics outlined above are not very pertinent to many state level program administrations/directors that I currently work with. I think I know a lot of this, but would be open to learning more. Especially as ACA unfolds. Faith based Nursing

Top number is the count of respondents selecting the option. Bottom % is percent of the total respondents selecting the option. Very Uninterested Neutral Very Interested operational systems you work with each day such as medication administration, supplies distribution, patient admission, 17 11 44 34 22 discharge planning organizational structure of the nursing department in your current work environment organizational structure of your employing agency (ex. ownership, legal requirements, services offered, individual departments, committees, etc) the variety of facility and provider types (clinics, hospitals, rehab facilities, nursing facilities, assisted living centers, home health, home care services) in your community and how your employer and physicians relate to them the outside forces that have shaped and will shape the healthcare industry (regulatory, payment, professional organizations, academic centers) the variety of payer types such as private insurance, Medicare and Medicaid and uncompensated care and the qualifications and requirements for eligibility for each level of payer 13% 9% 34% 27% 17% 12 12 50 33 21 9% 9% 39% 26% 16% 13 9 53 30 21 10% 7% 42% 24% 17% 14 7 37 43 27 11% 5% 29% 34% 21% 4 2 29 48 44 3% 2% 23% 38% 35% 9 8 30 45 37 7% 6% 23% 35% 29%

3. The Change and Innovation Group is interested in what aspect of change that would be of interest for a leadership training program. Change and Innovation Interested and Very Interested Rate the importance of course content on how to approach and implement a change process in your current nursing role? Rate the importance of course content on how to adapt to a change process as it relates to you in your nursing role? 69% 68% Are you interested in implementing a change process in your organization? 56% 0% 10% 20% 30% 40% 50% 60% 70% 80% Change theories. Kotter is one of several would be interesting to hear more of the theories and how they are put into practice/change. The CNS role is all about being a change agent. I am currently implementing a change process in my organization.

Top number is the count of respondents selecting the option. Bottom % is percent of the total respondents selecting the option. Very Uninterested Neutral Very Interested Are you interested in implementing a 6 7 44 41 31 change process in your organization? 5% 5% 34% 32% 24% Rate the importance of course content on how to adapt to a change process as it 3 5 35 65 23 relates to you in your nursing role? Rate the importance of course content on how to approach and implement a change process in your current nursing role? 2% 4% 27% 50% 18% 4 5 31 61 31 3% 4% 23% 46% 23%

4. The Communication group would like your input on your interest on several topical areas in communication. Communications Interested and Very Interested learning how to establish healthy relationships with 68% learning how to be assertive 59% learning how to more present-centered at work 70% learning about de-briefing strategies after a critical incident learning about emotional intelligence 64% 67% learning about reflective practice clarifying your roles and responsibilities as a nurse an exploration of the personal beliefs regarding your 55% 55% 56% 0% 10% 20% 30% 40% 50% 60% 70% 80% These are all good. With emotional intelligence it would be good to address lateral violence. Debriefing strategies are vital to prevent compassion fatigue- I have an written an article- published and done a few presentations related to compassion fatigue. I would be interested in creating a webinar sometime- Stacey Pfenning http//urgentmatters.org/e-newsletter/current_issue/cs_10.3 This is very important as well as differences i work ethics of various ages and people And how to booster a team spirit backbiting and tri-angulation! Work in an outstanding team - at the end of my career and ideas above not of great interest. Learning how to resolve conflicts is also needed.

an exploration of the personal beliefs regarding your behavior at work clarifying your roles and responsibilities as a nurse learning about reflective practice learning about emotional intelligence learning about de-briefing strategies after a critical incident learning how to more present-centered at work learning how to be assertive learning how to establish healthy relationships with colleagues at work Very Uninterested Neutral Very Interested 7 4 45 51 21 5% 3% 35% 40% 16% 7 9 43 43 28 5% 7% 33% 33% 22% 6 7 46 43 28 5% 5% 35% 33% 22% 5 6 31 50 36 4% 5% 24% 39% 28% 5 6 36 43 38 4% 5% 28% 34% 30% 2 6 31 58 33 2% 5% 24% 45% 25% 5 5 42 39 38 4% 4% 33% 30% 29% 3 6 32 50 38 2% 5% 25% 39% 29%

5. How closely do you follow health-care related policy proposals? Top number is the count of respondents selecting the option. Bottom % is percent of the total respondents selecting the option. Not at all Neutral Very Closely 6 16 33 53 23 5% 12% 25% 40% 18% Specifically State regulations that are on for review/adaption and affect nursing practice. They are not typically shared until the upper echelon has approved and then distributed. but would like to have more succinct information available in quick report form from NDNA As an advanced practice provider this is very important to my work. more information on affordable health care act. community needs more, too much politics trying to make it a negative thing 6. If asked by a colleague or friend for information about a healthcare-related policy initiative that is being considered by Congress or the state legislature, how confident are you that you could direct that person to where to find the information? Top number is the count of respondents selecting the option. Bottom % is percent of the total respondents selecting the option. Not Confident Neutral Very Confident 18 21 38 37 17 14% 16% 29% 28% 13% My daughter was a Senate employee and currently is the executive director of not-for profit at the American HealthCare Association in Washington, DC.

7. How likely are you to contact an elected official to voice your concerns or your support of a health-care related policy? Top number is the count of respondents selecting the option. Bottom % is percent of the total respondents selecting the option. Not Likely Neutral Very Likely 15 16 37 35 27 12% 12% 28% 27% 21% The Center for Nursing updates are great. This is important If provided the information on how to go about contacting the correct person(s). 8. What information/education do you need to feel more confident with discussing healthcare-related policy? those in the field with experience-networking Information re current legislative issues regarding healthcare in the state and who to contact regarding these issues Step-wise process is always helpful (walk-through) what the bill is and how it will affect health-related policy. In normal language summarized bills (policies) that are introduced, along with the pros and cons from the nursing/healthcare perspective I do not feel I have the understanding of how the process works and how to navigate information related to policy proposals. This is an area I am not seasoned in. None, I hold a PhD Where you even go to get the information they need to put in laymans terms so it is understandable time in order to keep up with legislative changes and issues. Where to find the language of policy proposed for change prior to laws being passed/implemented. know the bottom line Perhaps a center for nursing website location for day to day updates Receive new ND statutes/rule etc Unbiased presentation of actual verbage and interpretation of the policies proposed in a brief concise format. A mentor! any, but their policies in how they read things (the underlings) and then pass on the call/letter need to be better understood Information on where to find reliable healthcare related information (without political leanings).

More about the ACA Understanding the role of policy and how it governs the front line. I prefer to start with accurate, balanced information/facts and then make the topic more understandable by relating it to personal on-the-job experiences to lend credibility. understanding that public officials want to hear from their constituents. A presentation on how current the Affordable Care Act affects patients, learning more about both the positives and negatives would be helpful, such as how many people will see higher health insurance and how it will affect the work force. For example, will more employers now hire only part-time employees? What are the issues? I would like it if someone or an organization would outline the issues in a non political view point. What would legislation mean for me as the practicing nurse. more information needs to be made available what the real information is. there is so much negative, lies and fear tactics for the public. Where to find the information Information to support bill: why needed, who will it help, how do we make it happen, pros and cons, long term benefits content specific information FAQs concrete understanding of the policy in question where to find info, who to contact with concerns. The awareness of the policy. Knowing where I can find out more about them. I like short informational papers 1-2 pages with bulleted lists, pros and cons. Affordable health care act education/training efficiency and process improvement- balance that works. its complex-info that is easy to understand and articulate. Have trouble keeping up with the reading. an easily accessible bulleted list that contains pertinent, reliable information not really sure writing/discussing policy is an art and a science as we all know! Re-education regarding proper ways to write policy would be helpful. more self-awareness lobbying intro, mentorship payors and ACA how to put profiles online or "out" so hospitals, nursing homes etc. could see if a nurse is interested in being part of a board of directors so there are voting privileges understanding ACA and impacts will have with rollout. Short term impact on insurance and healthcare providers. Resources available. Resources Policy structure, public speaking Visit to capitol. Meeting with legislators, sit in the chambers. Background information leading to the policy- supporting data, groups sponsoring, groups advisory Learn about the issues, supportive to change I need a healthcare policy/politics for dummies book or fact sheet

Nursing responsibilities in patient care, all aspects. Summary of relevant issues-not from the media- from the Center for Health- like the Associations do? Very non-informative of the details of Obamacare No background information and where policy is now. what the changes are that are being proposed. More information on how the policies affect nursing. Information on current health-care policies. 9. What information/education do you need to feel more confident with contacting elected officials? how to be informed on issues and what my colleagues are advocating for Information re. current legislative issues regarding healthcare in the state and who to contact regarding these issues Media training (developing the elevator speech, speaking on behalf of news etc.) it would be great to see nurses talk about colds, heat stroke etc in addition to physicians. Interviews with local stations. This would also help with talking with legislators. Nurse Deb presented at AANP regional a few years ago. What are the protocols on calling and visiting bills that are pertinent to the healthcare system that have been introduced and passed or failed - and the voting records of individual legislators Understanding the process. None none If I can read more about proposed bills and all add ons to legislation. being more informed - in simple terms not legalistic ones Feel comfortable phone numbers, addresses, template letters Timeliness. A Mentor! process...who is it that you will be talking with, because it won't be the elected official! The needs of nursing as a whole. Specific bill numbers or better yet, local contacts in town to develop a relationship with. Or the specific health care contact in their staff. Policy information and appropriate processes to communicate effectively. Mainly it doing my "homework" so I feel I have something of relevance to say to officials. your voice is wanted! What are the issues that will form policies? What would a new law or policies mean for me as a nurse or the nursing profession. How to contact the elected officials and what do I say? I do not feel like I know where to obtain any of this info at this time

none, just go on their web site names and addresses protocol- what to do, what not to do, make best use of time- be prepared ahead of time content specific information FAQs concrete understanding of the policy in question- to know the policy at what it involves. who to contact, format, how to contact? Knowing who to contact with specific policy, who is the best contact to get the best results. I like short informational papers 1-2 pages with bulleted lists, pros and cons. names of officials and contact info need to be able to articulate information regarding potential policy changes- re need talking points to help educate myself so that I can feel comfortable knowing what I am talking about. a how to that could be accessed online because if you don't do it often- you lose this information. none really Some sort of format so as not to miss any important points of a particular position or topic etc. a mentor payors and ACA lists online/policy and the public (what is new, what is proposed?), any health policy usually affects nursing Okay with this. best way to reach with contact info. Contact Info. How to effectively word my suggestions. more on lobby vs. advocacy when funded by grant dollars Background on sponsoring group and/or committees what effect would it have on patients and families and healthcare workers who specifically for MN and ND (Moorhead/Fargo) do I contact? What type of things are worth contacting them about? Not sure Summary of relevant issues-not from the media- from the Center for Health- like the Associations do? need to get educated on the details of Obamacare Probably not going to do this as not that aggressive. who they are and what the changes even are. General information about healthcare related policies. How to write/email an appropriate professional policy letter.

10. Any other thoughts or suggestions for future leadership training in North Dakota? online leadership development, resource center with tools/modules, available on demand I think we are doing our states children a great disservice not having nurses in every building every day. Get rid of the nurses at UND Con making a mess of the college. Leadership is not a Barbie doll contest and that is what we have now. Nursing is much more than caring for patients. This information needs to be taught in college as well before the nurse gets into the work force. No more meetings like the one October 4th. Waste of time and money no North Dakota needs to resume the stance to have the BSN degree as a requirement for entry into practice for registered nurses. If we are to move leadership and our profession forward we need to demonstrate our commitment to advanced educational preparation for our nurses! This needs to be addressed in leadership training!! How do nurses become educated on the distribution of money and its allocation when working with government rules and employment administration? Why can't things be held in Grand Forks, why are most things in Fargo? They should hold things in major cities like Dickenson, Minot, Grand Forks... maybe others. There are many levels of leadership training that can be valuable. An introductory-type course for those who are not in a formal leadership role is good, but many of us who are in leadership roles could use more advanced training locally to make it possible to gain skills without significant travel expense. Bring in new leadership to the hospitals. Too many of their upper management people have been there too long and are not open to the change of practice philosophy required for new growth. These people just serve in these positions too long. There should be time limitations of service in these positions. Find 10 or more centrally geographic area with a nurse leader who is interested in developing that region. Give the leaders the resources (information, support, speakers) to reach every nurse in that area. We need to grow young nurses into leaders. rural health care bridging gaps/building infrastructure for the western part of the state, how to recruit and retain staff, how to promote a culture of change and process improvement, interdisciplinary communication and positive working relationships with Pharm Ds/NPs to be all on the same page. Great beginning= you are already implementing change! nurse healers, Christian nursing-blessings to you all, mentorships, compassion fatigue, policy writing, informatics, EHR improvement, HIPPA under new health laws, HIPAA is a joke in our society culture! We need to use data to save lives! Health care/data ERRORs- how they are killing over 100,000 people every year in the US!! Care-Compassion! breakout sessions- would like to have more time networking with APRNs! Network outside nursing- have nursing leaders and leaders from other groups such as media, academics, other disciplines, legislators etc. Business operations

continue to present the vision and tie the ND work to national to minimize duplication of effort and to share or partner with other projects (states). increasing nursing continuing education requirements, changing healthcare arena in North Dakota to include more nurses in policy and decision-making process. None at this time. Increase education, Increase be informed/communication less meeting in small groups, more lecture Great job! Thank you!