Nursing leadership and management phần 86

24Jones Leadership(F)-ch 24 1/14/07 3:56 PM Page 403 Career Development verb, referring to meeting people for the purpose of establishing links or contacts to further a goal Hisrich (1990) found that “the density of the entrepreneur’s business contacts or linkages” was important to start a new business and that “maintaining contacts were a significant predictor for early profit” (p 6) For the nurse, it means becoming visible, getting to know people in other areas of the job site, finding out what they and who they know A more formal definition is offered by Benton (1997): “a way of establishing and using contacts for information, support and other assistance to further career goals, or as a way of building relationships” (p 58) Most networks are made up of people who are receptive to communicating with one another Benton sees the benefit of networks as a vehicle to gather “feedback” on a particular issue or on the nurse’s performance It may be a way for the nurse to “influence” or be influenced by a particular point of view One of the more traditional reasons to network is to act on or procure a “referral” (p 59) A network can also act as an excellent advertising vehicle (Hisrich, 1990): “satisfied customers help establish a winning business reputation and promote goodwill” (p 6) Many individuals network to test the job market or to help secure a position outside of the organization For the intrapreneur or entrepreneur, it may help to locate an area of need within the organization This can serve as a springboard to fill the vacancy either permanently or temporarily as a consultant Some nurses are afraid to network because they think that it will involve small talk and taking advantage of a colleague or friend Networking should be mutually advantageous for both parties involved It is important that this give-and-take be implied at the outset It may be difficult to see the immediate monetary or career rewards to networking because some contacts take more than one meeting in order to cultivate useful information But at the very least a foundation has been formed Beck and Utz (1996) sees the benefits as “increasing contacts, sharing resources, and gaining peer support to contribute to an ultimate goal” (p 786) Networking is also “an effective means of fulfilling [the] responsibility of collegiality, while at the same time achieving personal and professional goals” (p 786) Benton (1997) advises that successful networking is a “dynamic process,” so it is important to strike a balance, keeping in touch with contacts but not becoming a nuisance Follow up promptly on a 403 promise of information or help, as reciprocity of a favor may be important in the future It is important not to ask for favors or information that the person is unable to provide Discretion is also extremely important as comments made to one person about another are bound to reach the ears of the one discussed, especially if the network is small (p 52) It is always advantageous to carry a good supply of business cards Some nurses carry more than one type; one may describe the current job, and another highlights the nurse’s intrapreneurial or entrepreneurial abilities Obviously, this is also a good way of marketing one’s skills or product Within an organization, it is important to approach people who work in unfamiliar areas and get information on what their jobs entail and how their departments function The nurse can approach a staff member whom she would like to know better and offer to treat the person to lunch in exchange for some information about how that person does an assigned job The colleague will probably be flattered if the nurse is diplomatic Benton (1997) recommends getting on mailing lists of professional organizations so that follow-up is possible with members related to newsletter submissions and advises the nurse to write or e-mail journal authors to establish contact and “open up a new network connection” (p 53) West (1997) offers many useful networking strategies, particularly if a new position is sought When attending a large professional conference, circulate and meet as many new contacts as possible, disseminating business cards and collecting them from all When a new contact asks, “What you do?” it is best to describe it in behavioral terms to highlight particular skills It is advisable to write notes on the back of the person’s business card so that pertinent information is not forgotten Even if a new permanent position is not being sought, finding out from contacts and nursing journals about vacant jobs will give useful information about where professional expertise may be needed and consultation opportunities exist Whenever there is a chance to meet new people, it is also a good idea to have an updated résumé Sometimes, a potential client is so enthusiastic that he will ask for one It is beneficial to join professional organizations and volunteer to serve on committees or task forces (Benton, 1997) West (1997) advises “diversification of the networking group by adding social acquaintances, college classmates, alumni, profes- 24Jones Leadership(F)-ch 24 404 1/14/07 3:56 PM Page 404 Skills for a Successful Career sors, church ministers, church members, and local business and social club officials Even the family lawyer, doctor, dentist, insurance agent, and banker may be in a position to help” (p 334) Web logs, known as blogs, are an emerging writing tool that is easy to use and that can enhance health professionals’ communication, collaboration, and information-gathering skills and help to manage information, diminish medical error, and support decision making (Maag, 2005) Nurses can read and comment on others’ blogs as well as starting blogs themselves Maag noted that “Daily blogging will enhance positive writing skills, instill selfconfidence in voicing personal opinions, and promote reflective thinking that, in turn, will allow the writer to appreciate his or her personal opinions or ideas” (p 2) Bloggers must be careful about what they write online; a number of bloggers have been fired for criticizing their employers or presenting themselves in an unprofessional way online Getting in touch with a wide range of global information and insight will facilitate knowing and becoming known Having a perspective on worldwide nursing issues gives the professional an ability to interpret situations with greater accuracy MENTORS The other concept that is vital to a successful career as an intrapreneur or entrepreneur is mentorship The term “mentor” is originally from the Greek legends and “refers to Mentor, the loyal friend and wise advisor to Odysseus and the teacher and guardian of Odysseus’ son Telemachus” (MerriamWebster, 2005) (p 920) The individual needs a personal moral support and a morale-building system and a professional network of contacts and advisors A role model who will agree to give counsel and act as a sounding board for potential career plans and activities is an invaluable resource, particularly at the inception of a new business venture or even at the beginning of a nursing career Byrne and Keefe (2002) describe a shift “in the nursing literature from an early emphasis on mentoring primarily for executive leadership roles to a current emphasis on special mentorships for clinician, researcher and other roles” (p 391) Recommendations for mentoring of clinicians include support of new RN graduates (Andrews and Wallis, 1999; cited in Byrne and Keefe, 2002), novice nurse prac- titioners (Hayes, 1998, and Hockenberry-Eaton & Kline, 1995; cited in Byrne and Keefe, 2002), and nurses making specialty transitions (Esper, 1999; cited in Byrne and Keefe, 2002) Byrne and Keefe noted, “Within nursing the experience of mentoring has sometimes been perceived as a learning continuum which extends from peer support and role modeling, through instructive preceptorship, selfinitiated and guided networking, and finally the intense and personal occurrence of focused mentorship” (p 396) Nursing is unique in that newly acquired knowledge, whether evidence-based or hypothesis-related, can almost immediately be put into practice Nurses can immediately evaluate a plan of action according to its risk/benefit probability and, by using critical thinking, develop a shortterm evaluation of the consequences, both positive and negative If new nurses burn out because of the lack of available support and advice, they will not survive the rigors of the initial practice environment to become advanced practitioners, intrapreneurs, and entrepreneurs Nurses are cognizant of the need to support, encourage, and teach new graduates and novice practitioners and are committed to helping them become competent, self-confident, and enthusiastic nurses Having a mentor within an organization can help a budding intrapreneur to gauge the advisability of assuming a new role Finding someone who has worked in the same place for a number of years is a bonus; he knows the history of various programs and people He can give a synopsis of what has been tried and why it was dropped or changed This is vital information for the nurse who is planning to offer a “unique” and important service in order to occupy a niche within the hospital, healthcare center, or community facility A mentor can give helpful feedback on ideas and proposals before they are presented Temporary setbacks can be analyzed and a new plan theorized For the nurse entrepreneur, it is advisable to seek a mentor with a business background as well as another within the health-care sector Nurse Intrapreneurs A comprehensive perspective on the development of intrapreneurs and entrepreneurs in nursing 24Jones Leadership(F)-ch 24 1/14/07 3:56 PM Page 405 Career Development involves looking at the qualities, roles, options, and successes of each designation QUALITIES As described by Gifford Pinchot in 1986 relating to the corporate sector, “intrapreneur” refers to a person who wants to be entrepreneurial but does not want to change his/her workplace “Behind most successful nurse leaders, executives, and entrepreneurs winds a long road of successful intrapreneurship, or innovation within an organization” (Manion, 2001, p 5) The nurse intrapreneur develops skills that are needed by the organization, thus creating a visible, marketable, talent niche “These professionals are continually seeking and recognizing opportunities for personal growth and development and are undeterred by typical organizational barriers to innovation” (Manion, 2001, p 5) Because many of the intrapreneur’s skills and internal innovations save the facility money, the organization directly benefits from the service Intrapreneurs are loyal to the organization and want to be useful and feel appreciated They are also confident, assertive, and willing to speak up when they see a situation that could be ameliorated or made more efficient They are open to exploring new ideas, not mired in traditional mindsets or bound by convention They can take two “old” environmental objects and synthesize a new one that becomes more than the sum of its parts This nurse is also typically talented, innovative, and proactive; the facility wants to keep this valuable nurse on its payroll rather than lose the intrapreneur to a competitor ROLES How can a nurse become an intrapreneur? Having a creative outlook is the first step “The greatest obstacle to workplace creativity is the we-alwaysdo-it-this-way mentality” (Cohen, 2002, p 10) Intrapreneurs may recognize systems that need changing, skills that will become necessary to master new equipment, better ideas for organizing or sorting data or personnel—the possibilities are endless By becoming a valued contributor to an organization, the nurse can build job security and increase professional and personal satisfaction with 405 her career trajectory One of the first steps is to get to know people in the organization and find out what they Having a network of individuals will help to identify problems and how they may have been solved in other departments Finding multiple mentors is also important; they may all have expertise in different areas and may offer many possibilities for innovation It is also important to look at the strategic plan and see where the organization will go in the future An important tactic involves volunteering for task forces and committee assignments It is both a good way to meet people and will acquaint the budding intrapreneur with the way the organization solves problems with its people and who has the power to make change It is also important to adopt a philosophy of lifelong learning, to stay current in the newest innovations in nursing, and to be aware of what is happening in other fields The intrapreneur needs to research what therapies are innovative and how they are being implemented at the facility; the next step would be to write an article for publication or make a presentation to other facilities Entrepreneurs may be competitive with an established company, but the nurse intrapreneurs can maintain their security within the facility Koch (1996) noted intrapreneurs “capitalize on the reputation of the organization and can readily access a diverse network of professionals who are crucial for answering questions, giving assistance and helping make ideas become realities” (Koch, 1996, p 2) Nurse intrapreneurs can also utilize the facilities’ meeting areas, copying, and Internet services, saving them the financial outlay that entrepreneurs must absorb as part of the cost of doing business on their own Intrapreneurs have the relative safety to discuss new ideas as a means to a possible “intraprise” without worrying that someone from within the organization will steal their innovation What kind of culture would welcome the nurse intrapreneur? There must be a dynamic mindset with “networking, teamwork, sponsors, and mentors abounding; trust and close working relationships where tasks are viewed as fun activities (not chores) with participants gladly putting in the amount of hours necessary to get the job done Instead of building barriers to protect turf, advice and cross-fertilization freely occur within and across functional areas and even divisions” (Hisrich, 1990, p 7) The environment, including 24Jones Leadership(F)-ch 24 406 1/14/07 3:56 PM Page 406 Skills for a Successful Career top management, needs to be open to new ideas and willing to experiment Of course, some hypotheses not work, and failure needs to be tolerated NURSE INTRAPRENEUR OPTIONS AND SUCCESSES l l For the umbrella organization, the nurse intrapreneur is visible as a change agent and a role model for other staff members who may also have good ideas, inspiring and influencing others to become innovators “while advancing the science of nursing through clarifying, refining, and expanding the nursing knowledge base” (Koch, 2004, p 9) One example is an operating room nurse who designed the “first hospital-based surgical recycling program in the country, a newly-created position of waste reduction specialist, and eventually into a national consulting business” (Manion, 2001) A nurse with demonstrated excellence in sterile technique and wound management might float from one hospital unit to another, helping nurses change complicated dressings or manage wound vacuum systems Keeping before-and-after pictures and showing how patient days and money were saved may make the hospital realize that a wound care nurse is an asset The hospital pays to send this nurse for an advanced certificate or to become a wound care specialist Similarly, a nurse with experience with colostomies or ileostomies might become an enterostomal therapist A nurse with a combination of computer and clinical expertise can become the in-house informatics consultant, responsible for orienting new staff, troubleshooting system glitches, and formulating new ways to use technology at the bedside Some health-care facilities will have computers with Internet capabilities available at the bedside It will be important for a nurse with computer expertise to help patients select and navigate the many healthcare consumer Web sites for information, to be someone who can integrate the education according to the disease and wellness needs of the patient Nursing job niches are only limited to the imagination of the nurse intrapreneur A nurse with children may create a job where there is the possibility of working at home or at an adjacent day-care site Perhaps self-staffing began with nurses deciding that they could it better Traveling nurses, with experience in many cities and job sites, may bring new ideas about doing things to each site, making them very desirable as permanent hires should they decide to stay A nurse who enjoys animals may volunteer while a pet visits its owners who are hospitalized or living in a rehabilitation center and may eventually convince her supervisor that a resident dog or cat needs her constant services as a petpatient liaison Facilities are always looking for an idea that they can promote to capture a particular market and become more competitive It may just take a nurse intrapreneur to point them in a promising direction Nurse Entrepreneurs It is important to compare the previously discussed qualities, roles, and options of the nurse intrapreneur with those of the nurse entrepreneur There are many similarities but also some marked differences QUALITIES It is important to look at the component parts of the nurse entrepreneur definition and assess whether the individual has what it takes to become selfmade and successful The definition speaks to a talented, independent, and experienced nurse who sees an available health-care business niche and decides to fill it Consider what the individual does well professionally as well as what she likes and wants to Many entrepreneurs were once intrapreneurs with a particular talent that was recognized within an organization; subsequently, they embellished and magnified this talent so that other organizations would find it valuable also Sullivan and Christopher (1999) describe many of the characteristics that are desirable in order to become a successful nurse entrepreneur It is important to be a creative thinker and be willing to assume the leadership role to get an idea from concept to reality Being a decision maker who is action-oriented rather than deliberative is essential to make change happen quickly Having a high tolerance for ambiguity and knowing that there is always a transition period from the inception of an innovation until it finally takes a cohesive shape are integral to the role of entrepreneur It is important to include nurse entrepreneurial activities as a part of the educational curriculum for management courses (really, 24Jones Leadership(F)-ch 24 1/14/07 3:56 PM Page 407 Career Development at any level) to foster innovative ways to approach traditional patient care activities (Sullivan & Christopher, 1999) Sullivan noted, “Thus, it is possible to learn the basics of entrepreneurship while studying management, including strategic planning, continuous quality improvement, business plan development, marketing, management information systems, leadership, and financial management” (p 329) Although it is vital to practice nursing according to principles and care standards, it is also important to forgo rigidity and a procedural mindset ROLES Merriam-Webster defines entrepreneur as a “person who organizes and manages a business undertaking, assuming the risk for the sake of profit” (MerriamWebster, 2005) The term commonly refers to a selfmade individual with a good idea who, despite many setbacks, perseveres and becomes successful and wealthy The term has been used often in the business community The number of successful entrepreneurs and new companies has steadily increased, despite the high rate of failure for a fledgling business The American culture is particularly supportive of the process Hisrich (1990) noted, “Although dissatisfaction with various aspects of one’s job— challenge, promotional opportunities, frustration, and boredom—often motivates the launching of a new venture, previous technical and industry experience is important once the decision to launch has been made” (p 210) Whether a person possesses the qualities necessary for success in this venture may be determined by family support, education, personal motivation and, to some extent, age Hisrich (1990) noted, “Generally, male entrepreneurs tend to start their first significant venture in their early 30s whereas female entrepreneurs tend to this in their middle 30s.” Although independence is usually the primary motivating factor, “money is the second reason for starting a new venture for men, whereas job satisfaction, achievement, opportunity, and money are the reasons in rank order for women” (p 212) If the job that an entrepreneur desires is not attainable with current skills, then it is necessary to find out what is needed and acquire it Sometimes education will open the door to a new market Education does not have to occur in a traditional manner, but having a baccalaureate, master’s degree, 407 or doctorate will open doors to previously unattainable positions or establish the credibility necessary for consulting This will obviously be a longer-term goal, but with careful planning, the present company or hospital may actually pay for that credential as part of its employee benefits One or more certifications and practice in another area may pave the way for a different career path Accomplishing these things while still employed is time-consuming but may allow the nurse time to save money; extra startup money may be necessary later when beginning to work as an entrepreneur Perhaps a degree or certificate in law, hospital management, marketing, or business would complement the assets of a healthcare background The nurse must consider what will make her unique and sought as an entrepreneur Sometimes working in the desired area parttime or in an entry-level position will help identify what is needed and how it can be supplied Working with or observing a person who already has the desired type of job will supply invaluable experience, especially if it can be used as an apprenticeship Often a lack of experience is a stumbling block to moving into a new job Orientation and training are expensive for any organization, and if nurse entrepreneurs can “hit the ground running” they will have an advantage over the competition OPTIONS AND SUCCESSES There are many ways in which a nurse can make the leap to an entrepreneurial role For instance, a nurse who demonstrated excellence as a patient educator could become a corporate wellness coordinator The nurse who had a position as an educator could subcontract to other health-care agencies without educators Some hospitals and geriatric facilities have eliminated their educator positions as cost-cutting measures and now find that an educational consultant is cheaper than paying one fulltime A nurse manager who has coordinated care for multiple units has proven leadership ability; would-be coordinators might prove a marketable commodity “Current research on complementary therapies, such as music therapy, guided imagery, and relaxation, can provide a springboard for the nurse entrepreneur who wants to apply research to practice and/or education” (Sullivan & Christopher, 1999, p 332) A care manager or case manager may deliver registry or agency ser- ... 1998, and Hockenberry-Eaton & Kline, 1995; cited in Byrne and Keefe, 2002), and nurses making specialty transitions (Esper, 1999; cited in Byrne and Keefe, 2002) Byrne and Keefe noted, “Within nursing. .. support and a morale-building system and a professional network of contacts and advisors A role model who will agree to give counsel and act as a sounding board for potential career plans and activities... peer support and role modeling, through instructive preceptorship, selfinitiated and guided networking, and finally the intense and personal occurrence of focused mentorship” (p 396) Nursing is