The mission of the Honor Society of Nursing, Sigma Theta Tau International is to support the learning, knowledge and professional development of nurses committed to making a difference in health worldwide. That mission statement brings me, a practitioner in organizational learning—I’m not a nurse—to you, nurse leaders and nurse educators.
My job is to help people and organizations learn—to help them create beliefs, practices and structures that make them remarkable so they can concentrate on doing meaningful work that achieves results. My grandmother was an LPN in Chicago in the 1940s and ’50s, so I have a sentimental affinity with nurses. For my doctoral dissertation, I conducted research on the nature of wisdom in individuals and how they operate within organizations. My focus? The nursing workforce.
Why wisdom in nursing?
My grandmother may have inspired my interest in how nurses work, but it was the grim prediction of a shortfall in the nursing workforce—a shortage that will only be exacerbated as baby boomers age—that motivated me to contribute what I can to the nursing profession from the field of organizational learning. Combined with these drivers, my interest in the study of wisdom came from an intriguing line in a textbook that referred to wisdom as the pinnacle of adult learning (Merriam & Cafarella, 1999). If wisdom is indeed the pinnacle of adult learning, it made sense to me to illuminate the nature of wisdom in nursing, one of the most important but most vulnerable workforces in society.
Insights for the health care organization
What I learned from the 15 nurses who participated in my original study forms the foundation of the leadership work I do today. Below are three key insights from my research that nurse leaders can utilize to foster and support wisdom in their health care organizations. Fortified with these insights, educators and other nurse leaders can design organizations that promote and sustain a wise nursing workforce.
Insight 1: Wise nurses have passion in an aspect of nursing that often comes from facing a related personal challenge. Implication: Find out what nurses care about and feel passion for; don’t shy away from the personal. Listen longer and with greater care than feels comfortable. Be transparent about the challenges and strengths of the organization.
All of the nurses in my original study were passionately engaged in their work. Whether they were clinical nurses, nurse researchers and educators, or administrators in colleges of nursing, all believed they were doing the work they were meant to do. Moreover, one or two indelible life events, which could be thought of as personal challenges, catalyzed a cycle of self-discovery that led each nurse to discover his or her purpose and passion.
More insights from
Elle Allison
“Happy people doing meaningful work will change the world. Stress is a dreadful robber of happiness. We may not want to create a stress-free life, but we sure can create a stress-less life. And, we can 'stare back' at the destructive emotions of fear, anxiety, anger and attachment.”
As seen in these examples, the personal passions of these nurses correspond to what matters to others and to their hospitals’ performance. This point is key when it comes to program sustainability in a tough economy; resources must be used to advance the mission of the organization.
Nurse leaders can encourage and support passionate innovation in nurses by providing forums for sharing ideas and, quite simply, by listening to nurses as they work, participate in committees and interact in meetings. Listen to the stories nurses tell about their lives, and listen for what they love about their work. Simultaneously, be transparent and forthcoming about the goals and strategies of the organization, including persistent challenges. Promote on-the-job learning about nursing innovations that relate to these goals and challenges. When nurse leaders communicate important organizational information and listen well to others, they evoke musings and interactions that often uncover passion and lead to breakthrough ideas and insights (Johnson, 2010).
Passion leads to meaningful work, and meaningful work is a source of great happiness for people. Therefore, nurse leaders who feel passionate about their work, and boldly share their enthusiasm with others, provide a template that encourages the nurses they lead to regard their personal passions as essential to the success of the organization. As one wise nurse put it: “I’m willing to share my personal stories, and my students directly benefit. They feel encouraged to move in a career direction that uses their unique talents and makes them happy.” She adds, “A happy nurse is a therapeutic nurse.”
Insight 2: Through grace, synchronicity and even “dumb luck,” wise nurses find a way to make things happen. Implication: Remove barriers for people to do their work. Never add processes, layers and rules when you don’t have to.
One of my favorite stories from my research is that of Donea, who had just retired as dean of a college of nursing at a large university in the Southwest when I interviewed her.
Donea had come to nursing through a diploma nursing school, not through a university program. She told me, “Coming in from a diploma school background to a baccalaureate faculty was practically like coming into Tiffany’s with a Walmart background.” Referring to Donea’s credentials, the dean at the time, who was also her boss, told her: “You’re never going to get on the tenure track, and you’re never going to be able to stay here if you don’t do something about this.” She encouraged her to start a PhD program in educational administration with a minor in nursing.
This was a trickier proposal than might first appear because, in the early 1960s, the university did not offer a graduate program in nursing. But the dean was in the process of establishing one, so she told Donea, “Just get started and let’s see what happens.” Eventually, the master’s program in nursing was approved, which meant that Donea could apply the credits from her nursing classes to her PhD minor. When Donea eventually became dean of the same college of nursing, it was without a master’s degree but, as she said, “The people around me saw what I could do, and so they made it work.”
All organizations have rules, policies and procedures that, conceivably, allow them to operate with the least amount of ambiguity possible. Some organizations, however, resemble a Rube Goldberg contraption. Goldberg, you will recall, was a cartoonist and engineer who designed complex devices to indirectly accomplish simple tasks. His famous “automated” napkin, for example, performs a series of mechanical operations that involve, among other absurd components, a parrot, a pail, a cigarette lighter and a rocket, all of which eventually cause a napkin to sway back and forth and wipe the face of a person eating soup. Some organizations seem to thrive on burdening people with Rube Goldberg-like procedures that overcomplicate work and zap the energy right out of people. Lack of trust, fear that people won’t do their work or won’t do it well, and the need to control are often at the root of these cumbersome requirements (Allison & Reeves, 2012).
Whether it’s grace, synchronicity or dumb luck—whatever you want to call it—when nurse leaders pay attention to the work challenges and quandaries facing those around them, they often find ways to reduce and eliminate hindering complexities in the system and open direct routes to action that create predictable miracles (Jaworsky, 1998). Nurse leaders should regularly audit processes, comparing them to the real work people are expected to do. Do processes support timeliness of action as well as efficiency and effectiveness? Leaders must remember that organizational rules are made by people and can be changed by people. Like all resources in an organization, processes must support important work, not hinder it.
Insight 3: Wise nurses are resilient; they bounce forward rather quickly from setbacks. Implication: Encourage learning and innovation, resist nostalgia and take action in new realities.
Resilience is closely linked to ideas about how people develop wisdom. Wisdom researchers Randall and Kenyon (2001) observe, “Ordinary wisdom involves, paradoxically, growth through diminishment and gain through loss” (p. 100). In all cultures, wisdom—like resilience—is seen in those who learn from the trials and tribulations of the past and apply what they have learned to present circumstances.
Singer and songwriter Joan Baez is credited with saying, “Action is the antidote to despair.” These simple words capture two important and visible signs of resilience: Resilient people take action after a setback, and they resist the pull of nostalgia that falsely glamorizes the past.
The wise nurses in my study demonstrated a tendency to accelerate the development of personal resilience by regularly taking on challenges and responsibilities that placed them on steep learning curves that, in turn, required them to become even more resilient. One morning, for example, Donea agreed to take on the care of four of the sickest patients in the hospital. By evening, she found herself leading one of the first intensive care units in the region at the time.
Nurse leaders can increase resilience in an organization by inviting nurses such as Donea to take on new challenges, supporting them as they test and revise their approaches and, through reflective processes, coaching them, using data and impact stories to make improvements and revisions.
Renewal
Management guru Peter Drucker is known to have said that the foremost job of leaders is to take charge of their own energy and then orchestrate the energy of others. Without renewal, the human body, mind and spirit ache, and meaningful work becomes elusive. For that reason, the insights I’ve presented do double duty: They revitalize an organization, and they encourage and inspire individual nurses toward wisdom. RNL
Elle Allison, PhD, founder of Wisdom Out and co-founder of Renewal Coaching, conducts original and proprietary research about the nature of wisdom and how it works for individuals, couples, leaders and organizations. She is co-author of Renewal Coaching: Sustainable Change for Individuals and Organizations. Since 2000, she has conducted countless interviews of individuals and couples, from all phases of life and in all industries, who are identified as being wise by someone who knows them. What these Wisdom Makers have to say will be published in her forthcoming books, What Wise People Do and What Wise Couples Do. To learn more about Allison and her work, watch video clip.
References:
Allison, E., & Reeves, D. (2012). Renewal coaching fieldbook: Happy leaders doing meaningful work for a greater good. Manuscript submitted for publication.
Jaworsky, J. (1998). Synchronicity: The inner path of leadership. San Francisco: Berrett-Koehler Publishers.
Johnson, S. (2010). Where good ideas come from: The natural history of innovation. New York: Riverhead Books.
Merriam, S. B., & Caffarella, R. S. (1999). Learning in adulthood: A comprehensive guide (2nd ed.). San Francisco: Jossey-Bass.
Randall, W. L., & Kenyon, G. M. (2001). Ordinary wisdom: Biographical aging and the journey of life. Westport, CT: Praeger.
