Cheri Constantino-Shor is the Director of Professional Engagement and Nursing Excellence at the University of Washington Medical Center-Northwest in Seattle, Washington. She is responsible for collaborating with nursing leadership to enhance the ability of the organization to support nursing team engagement. She is also a mentor to leaders in supporting team member engagement and in championing initiatives that foster connection, resilience, and hope at University of Washington Medical Center.
Cheri first became interested in intentionally cultivating a healthy work environment in health care in about 2015 when she authored an online module on Lateral Violence for a Charge RN curriculum for the Association for Nurses in Professional Development. This was reinforced in 2018 when she served on the Academy of Medical-Surgical Nurses Healthy Practice Environment National Task Force.
Cheri is deeply passionate about empowering frontline healthcare teams to have a voice in making needed changes at both the departmental and organizational levels, so she sees her role as kind of a dream job. She also shares her passion more widely as an inspirational speaker to healthcare teams locally and nationally, always focused on supporting the emotional health of both healthcare workers and patients and on creating a healthy work environment in health care.
DD: What would you say is your area of expertise?
CCS: Well, I kind of consider myself a "jack of all trades, master of none," in the best possible way. I have had many different roles throughout my 28-year nursing career, and so I have learned a little bit about a great many things. I started my career in an inpatient step-down telemetry unit and have worked in various inpatient and ambulatory roles, including as a clinical nurse specialist in behavioral health. I've also held various leadership roles throughout my career. What I think I have become an expert in, is the importance of people feeling seen and heard. Whether that is as a leader, in discussing workplace violence prevention tactics or even in cultivating a healthy work environment for healthcare teams, we, as humans, have an innate desire to feel seen, heard, and understood by the people around us. Holding that value as paramount has served me well throughout my career.
DD: How would you describe your leadership philosophy?
CCS: I ascribe to the situational leadership model. I really think it is about assessing each unique situation and team and determining what strategy would best serve the group. I think one can really only apply this model if they are truly listening to the needs of the team. If I think back to those very early days of the pandemic and I think my team was more in need of direction, always with empathy and kindness, of course, but we were fragmented and fearful, and the team needed to feel safe. They needed to feel that leaders were calm and had their backs and that we were willing to gown up beside them and care for our patients with COVID-19.
And then there are times when what is needed is curiosity, flexibility, coaching, honesty, transparency, or encouraging reflection. At the end of the day, one of my guiding values is authenticity, and so that will always be a driver for how I lead. But, throughout the pandemic, I have learned that to be a strong leader, there are times when I have had to be brave in moments when I did not feel so. This clashed big-time with my inner authenticity meter and sometimes left me struggling to find direction. So, again, I'll come back to leadership being about being able to listen to my team, read the situation, check in with my inner compass, and then decide what is needed at this moment in time. And then give myself a big healthy dose of self-compassion for not always getting it just right.
DD: What are the significant professional milestones thus far in your career journey?
CCS: If you looked at my resume, you would see that I have tended to change jobs about every 3-4 years throughout my 28-year career. Some might see that as lacking loyalty to an organization, but I have always seen it as a strength. I can honestly say that I have never passed up a career advancement opportunity or been afraid to take a professional risk, and that has ultimately served me well. There were occasional times when I landed in a role that didn't align with my values, but I think I learned even more in those cases when I so clearly saw what I did not want.
In 2010, I was working on an IV team and my nurse manager encouraged me to get certified in infusion nursing. I was a single mom with two young children, and I honestly had never even considered it. I started studying and become immediately hooked. Not only did I get certified, but I went back to school the following year and graduated with my MSN in 2013. I really attribute that success to my manager who saw something in me and encouraged me to pursue additional education.
As leaders, we have an incredible ability to empower and grow our team members. I think mentorship is an essential part of our roles, and I continue to seek any opportunity to help another nurse on their journey.
DD: What advice do you have for nursing professional development practitioners in the context of today's health care and learning environments?
CCS: If I could wave a magic wand in today's healthcare world, it would be to create psychologically safe environments. I think healthcare leaders, including nursing professional development practitioners, have an outsized impact on organizational culture. We hold the power to create environments where people feel safe and feel comfortable speaking up, asking questions, and making needed changes. In the healthcare world, "nursing control over practice" is akin to self-actualization at the top of Maslow's hierarchy of needs.
I would be remiss to not mention the unthinkable impact of RaDonda Vaught, a former registered nurse, convicted of negligent homicide in Tennessee in March 2022 because of a medication error she made in 2017. For those not following this case, Vaught mistakenly administered vecuronium, a paralytic, instead of the intended preprocedural sedative Versed, likely resulting in the death of the patient. Vaught immediately admitted her error leading to the loss of her license in 2021. The American Nurses Association issued a statement on March 25, 2022, which included, "Health care delivery is highly complex. It is inevitable that mistakes will happen, and systems will fail. The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent. There are more effective and just mechanisms to examine errors, establish system improvements and take corrective action" (American Nurses Association, 2022).
It is imperative that today's leaders can connect with their teams and cultivate psychological safety, encouraging open sharing without defensiveness or risk of repercussions. When team members feel comfortable questioning things and openly admitting mistakes, we have the incredible opportunity to learn from one another and to address systemic gaps and opportunities. It is my belief that human potential can only truly be actualized in this type of environment. And right now, more than ever, if we intend to climb out from the incredible pandemic-related challenges health care continues to face, we need that type of leadership.
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