Leading with intention

Midwife and health service improvement coach Jane Stanfield

Jane Stanfield argues it’s not outside anybody’s realm to influence.

“It can be done within what you’re already doing but we do need a different perspective or broadening of your perspective to do it. Nobody needs any more work to do and nobody needs any more standards to achieve, we need to know how to influence within our core business or practice.”

Invest in non-clinical development

Begin to see from early on in your career that nonclinical development is professional development.

“If I had one message for our current and future generation of nurse and midwife leaders, it’s to look at literature outside of healthcare. What I’ve noticed with nurses on the floor is they think that professional development, if it’s not clinical, it’s not relevant.

“You get taught that clinical knowledge is so important but then we (nurses) feel like we don’t have the tools or know how to recognise and influence system decisions when the opportunity arises.

“Of course, you need to be clinically competent, and you might put 75-80% of your CPD time and funding to clinical if clinical is where your heart is but put 20-25% to wider professional development so that you understand the big picture.

“Once you’ve got that, once you understand that there is a big picture out there, then you have greater understanding of how to influence and be ‘part of the solution’ (energising) rather than the perpetual sense of ‘doing battle’ (de-energising) that just burns us out further.”

Ms Stanfield suggests: The Harvard Business Review; Neuroleadership Institute, Positive Psychology; Compassion Focussed Therapy (including Self Compassion); and follow relevant politicians and associations on social media.

Redefining the narrative

If as clinicians or in leadership and management we believe that meetings or gatherings where the relationships, interactions, strategies and planning happen, are secondary, then nothing’s ever going to change, says Ms Stanfield.

“We often put meetings a very low second under clinical care, which is a decent value to have in one sense. But if our leaders and managers cannot attend and commit to valuable meetings, then the status quo remains. The people who are at the meetings set the direction.

“If we don’t prioritise what is important (which may be strategic meetings), then nothing changes. And the irony is that by not attending you’re actually handing over your power to others who are present. So often the narrative of nurses is that we’re disempowered, underappreciated and undervalued. And I don’t negate that. But if you don’t attend where people are giving you a platform, then you’re not going to be heard, and you’re not prioritising that strategic perspective. The only way our ‘voice will be heard’ is if we are actually there.

“Nurses on the floor are always going to be busy. But if we’re being strategic, if we’re thinking months and weeks out, then part of it is to put it in your diary and months and weeks out, organise the roster, rearrange the clinic, whatever it might be. Remember it IS important and influential to be there.”

Do the best you can, but also maybe it’s the story and the narrative that has to change, suggests Ms Stanfield.

“You might say that the story and the narrative in nursing is that meetings are a waste of time and that they’re taking away from the important work, which is clinical.

“But if the story and the narrative is that meetings are strategic, give us a voice and mean we have some influence then that might change the perspective we take on meetings.”

Taking the opportunities

It’s really significant to differentiate between what we can’t control and what we can control, the latter is what we can influence, says Ms Stanfield.

“I don’t think we play in that field often enough as clinical nurses. What can you influence if you keep stepping in?

“As Stephen Covey puts it in his 7 Habits of Highly Effective People, if you keep stepping into your circle of influence, your circle of influence expands.

“Step by step along the way in my journey, I’ve just expanded my circle of influence. I haven’t forced anything. I haven’t been massively goal driven. I’ve let it emerge. I’ve set my direction and I’ve come to positions where I can influence people. I think if each of us as nurses is stepping into a position of influence just that little bit wider than where we’re actually clinically practising, then you could see a real shift.”

The big picture

If we don’t know what’s happening politically, we’re not there to influence, says Ms Stanfield.

“If we spend two hours a month becoming aware, we’ve got the influence. For example, With the current reforms to Medicare, and interest in nurse practitioners, we’re there.

“If clinical nurses with a specialist in wound dressings know what’s going on with Medicare, boom, they’re out of whatever’s holding them back and setting up practice with the right people over the next five years. It’s keeping that balance between the minutiae of what our specialty is and the big picture politically and health system wide.”

Focus on flow and waste

Influencing change often still happens randomly, so what are the purposeful levers to pull to shift an experience? Or if you’re in a position of leadership, what are the concrete levers you can pull to drive a culture?

According to Ms Stanfield, the four areas you influence in any business are: safety and reliability; team vitality; client patient experience; and efficiency and effectiveness (flow and waste). “What I say in clinical real nurse terms is – does it flow, and does it reduce waste?

“The CEO wants to know that it flows, reduces waste, and is safe and reliable. The patient wants to know that they’ll feel safe, that it flows, but it’s reliable. And your teammates want to know that it flows, that they’ll be off on time and that they’ll enjoy working there.

“So, you can influence whoever you happen to be sitting in front of because you can articulate it quickly. And those four pillars, just about guaranteed will match any strategic plan in most health systems. And that’s all that clinical nurses need to know. Use that narrative with your argument and you’re in.”

Jane Stanfield has 30 years’ experience in clinical midwifery and clinical governance, culture and leadership and health administration. She coaches leaders and teams to implement local, relevant culture change. Her leadership series includes staying well, neuroleadership, mindfulness, culture, emotions, leveraging strengths and strategic planning, alignment and accountability.

For more information, visit: www.jane stanfield.com.au or call Jane on 0402 012 397 for customised coaching or team workshops.

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