Registered Nurses Are the Largest Clinical Group Employed by Hospitals. Because They Are

Nurse Leader Succession Planning Toolkit Academy

Registered Nurses are the largest clinical group employed by hospitals. Because they are the largest group much attention is focused on nursing (Wisconsin Health Care Workforce Report- 2009). This report also urges serious caution related to the large number of retirements and reduction in hours that is expected in the future as experienced nurses age and make choices about retirement and hour reduction. Commitment to the professional development of nursing includes identifying future nurse leaders at all levels of organization. Today’s nurse leader is in his or her late 40s to early 60s with an average age of 52. Twenty nine percent of nurse executives will be retiring within five years. 1

A literature review identifies a clear priority to build an effective purposeful and ongoing succession management process for targeted positions within nursing including nurse executive and other nurse leaders. Mary Ann Ponti identified the following key strategies:2 1. Identify key positions. 2. Conduct a migration risk assessment 3. Establish core competencies a. Nurse Executive b. Director c. Manager 4. Identify high performers and conduct a needs assessment 5. Develop individualized progressive development plan and identify associated critical success factors. 6. Prioritize, coach and mentor high performers.

There are many resources available to assist with these six strategies and will be included in this plan. The American Organization of Nurse Executives has partnered with other professional organizations to identify the core competencies of the nurse executive as well as the nurse manager . These competencies are the guide for the attached needs assessment as well as the individualized progressive development plan. Competencies include communication, relationship management, knowledge of healthcare environment, leadership, professionalism and business skills and principles. The competencies have been tiered to progress in nature from manager to director to executive and can be incorporated into the performance evaluation,2

Another key strategy to effective succession management is the annual prioritization of key positions for both migration risk and criticality. The assessment identifies who is expected to retire or leave the organization and how critical the position is to the organization.2

1 Jones, Cheryl B. and Havens, Donna S. “Chief Nursing Officer Retention and Turnover: A Crisis Brewing?” Journal of Healthcare Management (March/April 2008). 2 Ponti, Mary-Anne,” Transition from Leadership Development to Succession Management”, Nursing Administration Quarterly, (May/June 2009) Identifying high performers within your organization to coach, mentor is another key strategy. The Wisconsin Organization of Nurse Executives provides a mentoring program for current nurse leaders or aspiring nurse leaders

Recommendations: Based on the literature review, the following tools will help in the development of a leadership succession plan : 1. Conduct Migration Risk Assessment on key leadership roles. (Attachment A) 2. Identify aspiring nurse leader or current nurse leader in your organization.(Attachment B) 3. Leaders to complete needs assessment developed by the AONE. (Go to AONE website to access nurse leader assessment tool) 4. Develop curriculum or attend AONE program (Attachment C) 5. Meet with leaders and develop an education plan to meet needs. 6. Identify mentor for nurse leader via WONE or leaders within your organization. (Attachment D) 7. Meet with leader quarterly to identify progress on plan.

Wisconsin Organization of Nurse Executives Migration Risk and Criticality Tool Attachment A Scale: Migration Risk Assessment measures who is expected to retire or leave the organization. Rate 1-5 based on the number of years leader is expected to stay in current position. Criticality of position is measured using 9 key areas: revenue, generation, scope of responsibility, span of service, area of future growth, physician relations, difficult to fill position, highly specialized positions, clinical or technical skills and difficulty outsourcing. The more criteria rated with “ 1 “ more than other positions increases the criticality of the position. Projected job change : Projected Criticality of position 1 year = 5 Revenue generation ___ Physician relations___ 1-2 years= 4 Scope of responsibility___ Span of service___ 2-3 years = 3 Area of future growth___ Difficult to fill position___ 3-4 years= 2 Difficulty outsourcing____ Clinical skills____ >5 years = 1 Highly specialized positions ___

Nurse Leader Position Migration Risk Criticality of Position Overall Score (1-5) (0-9) Nurse Executive

Pediatric Director

Medical Floor Director

Surgical Floor Director

Critical Care Services Director

Women’s Health Director

Surgical Services Director

Rehab Director

Emergency Dept Director

Nursing Service Director

Home Health Director

Dialysis Director

The higher the score the more focused attention should be placed on succession planning. Nursing Leadership Succession Plan Attachment B Name Current Leadership role Aspiring Leadership Development Plan Role Director CNO MSN as CNS and NP, checking into DNP

Director CNO/Executive BSN working on Masters Director Graduate in May Manager Director BSN

Staff Nurse Manager Associate Degree working on BSN

American Organization of Nurse Executives

Leadership Competency Model Attachment C

Leadership Competencies/Skills and Traits

The vision of the American Organization of Nurse Executives (AONE) is to shape the future of healthcare through innovative nursing leadership. Innovative nursing leadership requires that nurses in leadership positions are competent.

AONE believes that managers at all levels must be competent in:

I. Communication and Relationship-Building II. Knowledge of the Healthcare Environment III. Leadership IV. Professionalism V. Business skills While all nursing leaders share these competency domains, the emphasis on particular competencies will be different depending on the leader’s specific position in the organization.

I. Communication and relationship-building competencies include:  Effective communication  Relationship management  Influence of behaviors  Ability to work with diversity  Shared decision-making  Community involvement  Medical staff relationships  Academic relationships II. Knowledge of the healthcare environment includes:  Clinical practice knowledge  Patient care delivery models and work design knowledge  Healthcare economics knowledge  Healthcare policy knowledge  Understanding of governance  Understanding of evidence-based practice  Outcome measurement  Knowledge of and dedication to patient safety  Understanding of utilization/case management  Knowledge of quality improvement and metrics  Knowledge of risk management III. Leadership skills include:  Foundational thinking skills  Personal journey disciplines  The ability to use systems thinking  Succession planning  Change management

IV. Professionalism includes:  Personal and professional accountability  Career planning  Ethics  Evidence-based clinical and management practice  Advocacy for the clinical enterprise and for nursing practice  Active membership in professional organizations V. Business skills include:  Understanding of healthcare financing  Human resource management and development  Strategic management  Marketing  Information management and technology

Wisconsin Organization of Nurse Executive Mentoring Program Attachment D

Nurse Leader/Executive Mentoring Program

Guided by Vision, Integrity and Social Responsibility, WONE works to develop the leadership abilities of Nurse Leaders within Wisconsin through a structured Mentoring Program.

Our mentoring program encourages the personal and professional growth needed for our participants to be successful leaders and masters of influencing change.

The WONE Mentoring Program pairs New Nurse Leaders or aspiring Nurse Leaders (Mentee) with Accomplished Nursing Leaders (mentor) in our Health Care community. These relationships enable Mentees’ to develop an understanding of career progression and the skills and abilities required for successful leadership. Mentees’ also gain valuable individual feedback and other learning opportunities as decided.

What Is Mentoring?

History gives many examples of the value of mentoring. Perhaps Homer in the Odyssey chronicled the most famous instance. Homer tells us that around 1200 BC, the adventurer Odysseus made ready to leave for the siege of Troy. Before sailing, he appointed a guardian to his household. For the next ten years, this guardian acted faithfully as teacher, advisor, friend, and surrogate father to Telemachus, son of Odysseus. The mythical guardian’s name was Mentor. Homer’s story reflects one of the oldest attempts by a society to facilitate mentoring. It was customary in ancient Greece for young male citizens to be paired with older males in the hope that each boy would learn and emulate the values of his mentor, usually a friend of the boy’s father or a relative. The Greeks based these relationships on a basic principle of human survival: humans learn skills, culture, and values directly from other humans to whom they look up or admire.

Murray, M. (1991). Beyond the Myths and Magic of Mentoring

Mentoring within W-ONE

The Nurse Leader Mentoring Program is a key initiative of the W-ONE. W-ONE believes in the development of skills of the individual. Specifically, we are looking to the Mentors to help guide Mentees’ as they map out areas for their personal and professional development, request information about health care strategic business culture and health care operational standards/practices, and seek feedback about issues of concern/frustration. More generally, we are requesting that Mentors actively help our Mentees’ to “polish” them so that they stand out and excel.

Mentoring “WHO NEEDS IT” Anyone who would like to know more about some of the key leadership issues below:

How Do I:

 Manage through informal influence.  Cope with fear of obsolescence.  Manage role ambiguity.  Make decisions under increasing uncertainty.  Get the best out of other.  Resolve conflict.  Balance life and work priorities.  Improve emotional intelligence.  Manage time.  Foster leadership in others.

Mentoring “WHY BOTHER”

 Nurse Leaders/Executives are increasingly surrounded by forces they cannot control.  The demands are greater, so is the stress- a major challenge to be at our best under pressure.  Nurse Leader/Executives often cannot discuss personal issues openly with colleagues.  They are expected to know it all and do not need mentoring/coaching.  This old fashioned hero worship puts unrealistic pressure on today’s executives.  Too many subordinates will agree rather than risk disapproval.  An outsider can provide an objective sounding board and reality check.  Rapidly growing complexity will make the executive’s decisions harder not easier.  The pressure to achieve more from fewer people faster will mean more stress for all.  A psychologist may be able to help you get the best our yourself and others.  It won’t get any easier to balance out-of-work values and work pressures.

Mentor Roles and Responsibilities

A Mentor is someone who makes a difference in another person’s life. In your role as a Mentor, you will have the opportunity to do this with Nurse Leaders within the state of Wisconsin interested in a Mentor/Mentee partnership.

The partnership between a Mentor and Mentee is built upon trust, respect, and professionalism. Specifically, as a Mentor your role will be one of Coach, Guide, Motivator, Advisor, and Role Model. You will have the opportunity to:

 Provide constructive feedback about your Mentee’s personal and leadership skills.  Share your knowledge about specific leadership roles, organizational cultures, and industry standards.  Give guidance about how to conduct oneself in leadership and business settings.  Facilitate networking.  Coach and guide your Mentee toward achieving a specific developmental goal.

Responsibilities

 Communicate clearly the developmental goals that you will agree to work on with your Mentee.  Set realistic expectations regarding method and frequency of communication between you and your Mentee.  Be available and maintain consistent contact.  Listen to the Mentee.  Provide the Mentee with information about opportunities he/she should explore.  Give constructive feedback.

Mentee Roles and Responsibilities

A Mentee is a W-ONE member who is motivated to assume responsibility for her/his own professional and personal growth and development.

The partnership between a Mentor and Mentee is built upon a foundation of trust, respect, and professionalism. As a Mentee, you will have the opportunity to:

 Learn about specific leadership roles, organizational cultures, and health care as a business.  Receive constructive feedback about personal and business skills.  Obtain guidance about conducting yourself in health care/business settings.  Create a focused development plan with your Mentor and work towards achieving the stated goals.

Responsibilities

 Initiate contact.  Communicate your interests/needs/problems clearly.  Accept Mentor advice and feedback without becoming defensive.  Set realistic expectations of the Mentor.  Use the Mentee Learning and Development Plan to set the agenda for meetings.  Appreciate the mutual respect, trust, and openness between Mentee and Mentor (including confidentiality). The Do and Don’t for Mentors and Mentees

MENTOR DO:  Make efforts to keep your appointments with the Mentee.  Actively listen to questions and concerns.  Encourage discussion.  Approach discussions with an open mind.  Maintain a high level of trust and professionalism.  Respect confidentiality.  Contact the Center for Leadership Development if you are having trouble connecting with your Mentee or if business pressures prevent you from fulfilling your commitment. DON’T: Don’t hesitate to provide your Mentee with constructive feedback about areas for personal and professional development.  Don’t hesitate to contact your Mentee if you have not heard from her/him for a while.

MENTEE DO:  Initiate the contact with your Mentor.  Plan an agenda for each meeting - be focused.  Keep appointments with your Mentor and be punctual.  Approach discussions with an open mind.  Maintain a high level of trust and professionalism.  Respect confidentiality.  Accept constructive feedback from your Mentor.  Thank the Mentor for her/his time.  Maintain consistent contact with your Mentor, even when you do not have a pressing issue to discuss. DON’T:  Don’t hesitate to contact your Mentee if you have not heard from her/him for a while.  Do not neglect contacting your Mentor to set up meetings.

Documents can be found at www.w-one.org