According to the U.S. Bureau of Health Professions, the shortage of registered nurses will reach roughly 800,000 by 2020. Another concern: Will we have enough competent, skilled nurse leaders able to manage and navigate the increasingly complex world of health care?
In many cases, nurse leaders are appointed based on their clinical nursing ability or willingness to serve—not their ability to manage or lead. Ideally, nurse leaders should have a skillset that gives them a chance to succeed and flourish. West Virginia University Healthcare (WVUH) created a leadership development program called Charge Nurse University (CNU) to provide that skillset to future nurse leaders. It rewards nurses with high leadership potential and develops them as the next nurse leaders at WVUH.
CNU came about in response to nurse leaders’ request to explore ways to provide education to charge nurses. The goal of its creators was to give learners input into curriculum development. Over several months, focus groups were held with charge nurses and nurse managers to identify key educational needs to include in the curriculum. After their feedback was incorporated into curriculum development, the next step was to establish a solid foundation for program content. Nurse educators decided to build CNU’s curriculum foundation on the key competencies and skills identified by the American Organization of Nurse Executives (AONE) as common to nurses in executive practice.
Also vital to curriculum development was A Charge Nurse’s Guide: Navigating the Path of Leadership, a book by Cathy Leary and Scott Allen. At the first kickoff event (described below), where the curriculum was reviewed with participants, each participant received a copy of this book and was assigned specific chapters. Small groups then reviewed the chapters to discuss key points and foster critical thinking.
Selecting students for the inaugural class
After core components of the curriculum were developed, nurse leaders collaborated to select the nurses for CNU’s first class. Nurse managers and directors developed and used specific admission criteria: half of scheduled time spent in a charge nurse or leadership role, at least 2 years of nursing experience, no disciplinary action, interest in developing leadership skills, and willingness to commit to WVUH for 1 year after completing the class. The inaugural class included 56 nurses representing all major nursing departments and units.
Two kickoff events were held during the first 2 months of the CNU program, followed by three trimesters of classes. At the first event, the chief nursing officer explained why CNU was developed and how it relates to the overall succession plan for WVUH leadership and, more specifically, the nursing division. Participants received an overview of the curriculum and were advised of their role and responsibilities. They were able to verbalize their educational needs through an interactive activity called World Café. These needs were incorporated into the curriculum (which had been left somewhat open to allow such incorporation).
At the second kickoff event, participants discussed the role and behavioral styles of leaders, qualities of effective leaders, appropriate delegation, effective communication skills, and how to accommodate change and motivate the team.
As mentioned earlier, the CNU curriculum was based on the AONE competencies of business skills and principles, knowledge of the healthcare environment, and communication and relationship building. Each trimester addressed one of these competencies. Book reviews and elective sessions tied into the competencies; students were required to attend a book review session and one elective session each trimester. Each course was offered approximately six times per trimester at varying times for increased schedule flexibility to accommodate unit staffing.
To further engage participants in their leadership journey, each was assigned an advisor (a nurse educator) to help them navigate the program and curriculum. Advisors and participants touched base briefly each month, which gave advisors the opportunity to discuss key concepts and address specific issues of participants.
Support from senior organization leaders enabled CNU to provide in-house speakers for educational sessions. The chief financial officer gave a 2-hour course on budget and finance basics, called Finance and Budget 101, which covered such topics as how charge nurses’ daily decisions affect an organization’s budget. This was among the most popular courses; many students said it helped them grasp why and how budget decisions were made. House Supervisor Observation, an elective offered throughout the entire year, allowed participants to shadow the house supervisor during
either the 11-to-7 or 3-to-11 shift to help them understand the supervisor’s role and responsibilities.
During the second trimester, nearly twice as many courses were offered as during the first trimester. At this point, data obtained from the first kickoff on participants’ self-identified educational needs was incorporated and used to develop courses. As a result, several new courses were offered, including Customer Service and Service Recovery, Patient Safety and Risk Management, Scope and Standard of Nursing Practice in Leadership, and Root Cause Analysis Observation. These courses fall under AONE’s knowledge of the healthcare environment competency. During the third trimester, two more electives—Horizontal Violence and Nonviolent Crisis Intervention—were added to meet participants’ perceived need for more knowledge of communication and conflict-management skills.
To tie important concepts together and widen participants’ perspective, a final project was required. They could choose to shadow either a nurse manager/director or a fellow CNU participant during a shift as a charge nurse. Those considering pursuing management opportunities were encouraged to shadow a nurse manager/director. Afterward, participants were required to give a presentation on the experience to other CNU participants.
A commencement ceremony was held at the end of 2010 to recognize and celebrate the accomplishments, hard work, dedication, and engagement of CNU students, facilitators, and presenters of the CNU program. The keynote speaker for the day-long celebration was Debra Townsend, CEO of Concepts of Care. The main goal was for each student to leave with a final message—to know they had the power to use the tools they acquired at CNU.
Evaluating CNU’s effectiveness
So did CNU meet its goals and objectives? Overall goals were to:
- prepare nurses for potential leadership positions
- enable 15% of participants to obtain a leadership position within the first 2 years after completing CNU
- achieve an average of 4.5 out of 5 on a Likert scale for course evaluations.
These goals were met: CNU nurses were prepared for potential leadership positions; as of late 2012, 25% of those who attended CNU in 2010 have moved up in the organization. Also, we obtained an overall average of 4.8 out of 5 on a Likert scale for course evaluations.
For the second installment of CNU in 2012, the program curriculum was altered based on feedback from the first group of students. A different text was incorporated into the curriculum, and students used learning-management software called SOLE, which allowed them to blog and interact with each other. We hope this further engages them and gives them the knowledge and tools that will enable them to succeed in any position.
American Organization of Nurse Executives. The AONE nurse executive competencies. 2005. http://www.aone.org/resources/nec.pdf. Accessed October 22, 2012.
Leary C, Allen S. A Charge Nurse’s Guide: Navigating the Path of Leadership. Champaign, IL: Center for Leader Development; 2005.
Schweyer A; Human Capital Institute and Lawson Software. The state of talent management in the healthcare industry. May 2009. http://s3.amazonaws.com/rdcms-himss/files/production/public/HIMSSorg/Content/files/CareerServices/Lawson_TalentManagementWhitepaper.pdf. Accessed November 12, 2012.
U.S. Bureau of Health Professions. Projected supply, demand, and shortages of registered nurses: 2000-2020. July 2002. www.ahcancal.org/research_data/staffing/Documents/Registered_Nurse_Supply_Demand.pdf. Accessed November 11, 2012.
Heather Malcolm is a nurse clinician/education specialist at West Virginia University Healthcare in Morgantown.