Nursing and health care, as a whole, have had their challenges over the last several years. As the recovery from the pandemic has been slow, many health care organizations continue to struggle with the day-to-day challenges of adequate staffing, agency staffing, overcrowded emergency departments, capacity, and throughput. As we strive for stability and the need for dedicated, committed teams to provide the best care possible for our patients, I am reminded of my days as a new nurse (1986) and the years that I spent working as a bedside nurse in a busy Shock Trauma Intensive Care Unit at a Level I trauma center.
With my prehospital background and this exciting new world as a trauma and neurological critical care nurse, I had so much to learn. With strong, dedicated preceptors, I soon learned what it took to be a trauma/critical care nurse. When I reflect on those early years of my career, I remember feeling a sense of extreme dedication to our nursing team and the intensive care unit (ICU). With my nurse manager's ability to inspire and motivate staff to reach their full potential, our ICU thrived as we adopted "Shared Governance" as our professional practice model. Popularized in 1985, Tim Porter O'Grady, a pioneer for "Shared Governance," described this concept as "a structured model through which nurses can express and manage their practice with a higher level of professional autonomy."(p71)
With the transformational leadership style of our nurse manager, our team was committed to playing an active role in the governance of our unit. With the development of a unit council and various committees such as Staffing, Practice/PI, Education, and Reward and Recognition, our staff was empowered and accountable for shared decision-making regarding policies, processes, and procedures impacting patient care and staff satisfaction. During these years, in addition to my love of caring for people and ICU nursing, with an engaged staff and an effective leader, our percentage of staff burnout and turnover was minimal. In addition to improved patient care/outcomes, reduced costs, greater efficiencies, and improved staff engagement, nurses like me were encouraged to take on new leadership opportunities. I attribute these years of my career and my nurse manager, who inspired and influenced me to believe in myself and achieve my maximum potential, as the reasons why I choose leadership roles beyond the bedside.
Fast forward about 20 years after full-time bedside nursing to clinical education, management, and performance improvement roles, all in that same busy trauma program. Over the last 3 years, I have chosen an opportunity to work with a fabulous multidisciplinary team of clinicians, along with clinical and nonclinical leaders, in a small community hospital to become a Level II trauma center. Bringing together a "new" trauma team during the pandemic was amazing! Coming together as a clinical nurse specialist and trauma program manager along with other trauma clinicians to build a trauma program reminds me of my earlier years in nursing but now from the perspective of one of the leaders.
As one of the team leaders in this new endeavor, I had many questions to ponder. How was I going to motivate, engage, and empower staff to want to be part of the trauma team and share in the decision-making process regarding policies, patient care processes, and their professional practice? How do I get people involved in performance improvement, case reviews, and continuing education? How do I help recruit and retain nurses during the midst of change and during such a difficult time in health care? As a direct reflection of what I experienced in the first half of my career and the "leadership" that I was influenced by, I strive to be a leader who is present.
Leadership presence involves a combination of many characteristics, such as having the skill of communication and adaptability and the ability to motivate and inspire others (Cuddy, 2015). In her book, Presence: Bringing Your Boldest Self to Your Biggest Challenges, Dr. Amy Cuddy says, "Presence stems from believing in and trusting yourself-your real, honest feelings, values, and abilities."(p79) Elements of presence include confidence, comfort level, and passionate enthusiasm. It starts with being physically present but goes deeper than that. For me, it's about being present for staff on the clinical units on all shifts. It's about connecting, communicating with people, and creating a positive work environment. It's important to let colleagues know that you care by providing clinical support or guidance, answering questions, or helping to work through a problem. It's about lending a hand with patient care, visitors, or any tasks, big or small, that are needed to accomplish goals. Offering assistance and joining in to help, I believe, lends credibility as a leader. It verifies our technical and intellectual competence, allowing us as leaders to influence and communicate with others more effectively.
Another very important aspect of leadership presence is that of emotional presence. Emotional intelligence is the ability to recognize, understand, and deal skillfully with one's own emotions and the emotions of others (Merriam-Webster, 2023). It's important as a leader to be aware of and regulate your emotions. Having empathy for others will strengthen those relationships and leadership presence. I recently read a New York Times bestseller, Wolfpack, written by Abby Wambach, a FIFA World Cup champion and Olympic gold medalist. It's a great read for anyone trying to lead-a sports team, a health care team, or anything in life. The author speaks to her "New Rules" that she learned along her path in life. However, all of her rules are great lessons learned. The two that stick out for me are "Lead with humanity. Cultivate leaders" and "You're not alone. You've got your Pack" (Wambach, 2019).
As your President of the Society of Trauma Nurses (STN), I am humbled and blessed to be surrounded by the best nurses and trauma nurses worldwide. As I look at our current Board of Directors, our committee chairs, and members (our pack), I am amazed to see such wonderful trauma nurses actively participating in STN's many projects, educational offerings, collaborative efforts, and partnerships, all to achieve our mission and vision. I appreciate all I have learned over the years from this society, its members, and its leaders, and I look forward to ongoing opportunities to serve.
In June, STN sent out a call for volunteers to consider joining one of the many STN committees and Special Interest Groups. It was great to see many new and familiar member names taking the leap to get involved. If you missed the communication to sign up, it's not too late. Please reach out; opportunities are waiting! Together, our "Pack" can accomplish so much! Thank you for leading the way to improve trauma care for everyone everywhere!
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