The article begins:

"This is a tale about Amy, a busy leader with a vexing challenge. For 11 months, Amy had been the director of an emergency room in a large urban hospital. She is a seasoned, skilled nurse leader who is well intentioned and inspired to do her best."

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The article begins:

“Is there such a thing as too much change? Many of us would say yes. So what? Nurse leaders at all levels of a system must manage the amount of organizational change that is present, whether we think it is too much or not."

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The article begins:

“Our conference call was about to end. Just as this lively conversation amoungnurse leaders concluded, a participant said, "Can we talk about the imposter syndrome?"

The imposter syndrome? Of course we can talk about that! Since we were out of time, I decided to follow up privately with several participants, including Eve and Barbara. ..."

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The article begins:

“Some years ago, the rock group The Who immortalized the line "Meet the new boss... same as the old boss." Originally, these words symbolized the disappointment of a generation seeking but not finding large-scall change. Now, however, the prospect of no change is conforting to LuAnn..."

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The article begins:

“Just before we boarded the plane for our Midwest destination, my colleague and I received the news: the 3-day retreat we were about to convene might be cancelled. The cheif nursing office (CNO) who hired us had heard rumors that her team was not going to come, despite her careful planning. ..."

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The article begins:

“During our first meeting, Suze, a young nurse leader, appeared grounded, eager, filled with ambition, and clear about her goals. "I want to change the world" she announced. Her words and demeanor suggested that she is capable of doing just that, but she feels stalled in her current position. ..."

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The article begins:

“Not long ago, I was invited to work with a group of distinquished nurse leaders from around the country We were starting a year-long process that included individual executive coaching for each leader. As we dicussed our coming work together, it became clear that many of these leaders had concerns about time. ..."

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The article begins:

“Each year, Elsevier, the publisher of Nurse Leader, invites the attendees of the American Organization of Nurse Executives (AONE) Annual Meeting to submit questions for "The Coaching Forum." As I reviewed the April 2010 entries, I was struck by a common theme: how do we know when it's time to move on? ..."

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The article begins:

“Laurie is challenged with finding and keeping good managers. As a vice president of a
community health system, she understands the critical importance of this leadership function. Yet, despite her other strengths, Laurie is consistently unable to groom, guide, and evoke the best from the gifted nurses who report to her. ..."

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The article begins:

“Lucy began our conversation sounding breathy and exasperated. As the senior staff leader of a large healthcare organization, she voiced her anxiety about an emerging conflict between her board of directors and another organization. She had other concerns, too, but she was so emotional that she couldn’t articulate them. ..."

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The article begins:

“Not long ago, my colleague Jennifer visited a hospital that had engaged our team to work with their nursing leaders. Jennifer was convening a voluntary “brown bag” luncheon to check in with the program participants. She also promised to review a key program activity as the meeting ended. ..."

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The article begins:

“Jeff walked out of his supervisor’s office feeling good—mostly. He had just received his eval uation after a year on the job. Jeff is a nurse leader who holds a significant position in his health system, and he is very motivated to do well at work. He felt good because his review was very positive; on nearly every question with quantifiable measures, his manager said he exceeded expectations ...

But Jeff was disturbed by the comments his manager offered in the spirit of continuous improvement ..."

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The article begins:

“Kimberly was a successful service line director in a mid-sized medical center. The chief nursing officer (CNO) recently submitted her resignation after a lengthy tenure, and Kimberly was interested in her position. She had long felt that the CNO had retired on the job. Although the CNO was well liked in the organization, Kimberly was frustrated with her leadership, believing she herself was highly qualified and ready to take over. As Kimberly saw it, she had successfully implemented many new initiatives, was well regarded within the hospital, and deserved to be the CNO. She was eager to roll up her sleeves and do whatever was necessary to obtain the job."

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The article begins:

“Recently, I was invited to work with a team of directors of clinical services in a successful, medium-sized health system.When I met with these nine leaders for the first time, I was impressed by each member’s apparent competence and commitment. Despite their individual strengths, however, their results as a team were seriously lacking.

I was called in by the team leader to explore why the team was not performing well. ..."

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The article begins:

“A hospital in which I have spent a lot of time is undergoing major funding cuts. This community resource is part of a small health system, and it has earned a great reputation, especially recent years. Today, its leaders are making every effort to maintain its quality of care while taking anything remotely “excessive” out of its budget."

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The article begins:

“Karin is a department head in a major metropolitan medical center, and she brings a wealth of unique and valuable experience to her position. She is about 2 years from retirement. ... As we talked, she veered toward tears several times. Karin described her work life as excessively stressful, demanding, and exhausting. She said she had no time to think or to plan and that she was working far too much.

...In my role, I encounter too many nurse leaders like Karin.They are well intended, good hearted, and genuine. "

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The article begins:

“There is something exceptional about Grace.  She is a nurse executive with whom I have worked for several years, and recently she was promoted to the CEO role. … what led the leaders of this esteemed tertiary facility to select her? ..."

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The article begins:

This column is devoted to personal blind spots or “areas in which one inadvertently fails to exercise judgment or discrimination,” as Webster’s Dictionary defines them. ..."

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The article begins:

Let’s consider two scenarios. In the first, Karen is a nurse with 25 years of management and leadership experience. She wants a new job so she can use her full complement of leadership skills. She has all the right credentials, yet after 2 years of looking, she has been unable to secure a new position.

In the second scenario, Ramona is a vice president in a large health care system. She has eight nurse manager direct reports, and she recently terminated one of them, Cindy, because of Cindy’s lack of follow-through and her unwillingness to be accountable. Cindy’s poor performance affected patients, staff nurses, and Ramona’s other direct reports. ..."

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The article begins:

"A lot of nurse managers and leaders ask me how they can have better relation- ships with their bosses. The question comes in different forms, but the essence remains the same. See if you identify with any of these examples:

• “I need resources to get the job done, but every time I approach my boss, she is preoccupied, doesn’t listen, or just says ‘no.’”
• “My boss means well, but he doesn’t understand what’s going on in my unit." ...

These and other variations on the theme of strengthening our relationships with our bosses come up again and again in my executive coaching sessions. One best practice for managing this significant challenge is what I call 'coaching up.' ..."

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The article begins:

"Consider your team for a moment. Whether you are the nurse leader, a team supervisor, or a team member, think about how the nurse manager (you?) became the nurse manager. Did you or she have a plan to move into that role? Or did you arrive in the job by accident?

Now, consider other nurse managers you know. How did they arrive in those positions? Did they carefully guide their careers to this destination? ..."

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The article begins:

"Karen was a competent director of a core service unit at a major health care institution. She was well regarded by the unit’s nurse managers, educators and charge nurses. ...

Karen benefited greatly from her organization’s recognition and support of her developmental needs. But she also encountered a hard-to-surmount difficulty. As she discovered new approaches and possibilities for her unit, the unit’s day-to-day demands grew even more significant. Using the word “overwhelming” to portray them, Karen painted a verbal picture filled with compelling—and sometimes competing— responsibilities and tasks. She described the hospital’s circumstances in equally convincing terms, noting an overflowing ER and at-capacity occupancy. Karen was not whining. She was depicting realities that were hard to navigate. ..."

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The article begins:

"Sally, a “Coaching Forum” reader, recently complained about her boss’ behavior. Sally is the director of a service line in a large metropolitan hospital. She wrote to say that her boss, Linda, is wavering about a new program to which she had committed a few months earlier. The program is strategically important because it authorizes a new nursing role designed to improve the quality of patient outcomes and satisfaction. Based on Linda’s earlier commitment to the initiative, Sally nterviewed a number of nurses who were enthusiastic about the new positions. Sally also generated excitement among her existing nursing staff.

Now, it appears that Linda, the COO, is backpedaling on her earlier promise. Sally does not understand why Linda changed her mind, and she is angry and disappointed. ..."

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The article begins:

"The Nurse Leader editorial board, editor in chief, and I extend our sincere thanks to the many readers who submitted inquiries to “The Coaching Forum” during the 2007 AONE annual meeting in Washington, DC. A central concern emerged from your questions: what are the best ways to develop others when time is limited, your responsibilities are great, and the circumstances are taxing?

While difficult organizational realities are here to stay, there are simple strategies that can help you grow other people, even in demanding times. ..."

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The article begins:

"Katie is a competent 40-year-old nurse manager in a Midwestern community hospital. She is sharp, well prepared, and committed to her organization’s vision of quality patient care. In the past, she frequently suggested viable ways to achieve her unit’s goals and solve its problems. She made her recommendations even if they challenged the status quo.

Linda is a seasoned nurse leader in an academic medical center on the West Coast. She is a member of her hospital’s top executive team, and she has received numerous honors for her achievements throughout her career. Linda is passionate about excellence in patient care and nursing leadership.

Each of these nurse leaders recently experienced challenging encounters that left them feeling off-center and vulnerable. ..."

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The article begins:

"Recently, I coached a team of well-respected nurse leaders. We had embarked on a leadership development initiative to increase their effectiveness as individuals and as a group. We were well into a candid review of the team’s concerns and opportunities when one of the prominent group leaders said, “It would be nice if we could do that, but we can’t. Remember, the box we are in is very small. ...”

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The article begins:

"Recently, I coached a team of well-respected nurse leaders. We had embarked on a leadership development initiative to increase their effectiveness as individuals and as a group. We were well into a candid review of the team’s concerns and opportunities when one of the prominent group leaders said, “It would be nice if we could do that, but we can’t. Remember, the box we are in is very small. ...”

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The article begins:

"In her seminal work From Novice to Expert, Patricia Benner, RN, PhD,1 applied the Dreyfus Model of Skill Acquisition to the development of clinical nursing practice. I believe that much of the Dreyfus Model can be applied to the development of new nurse managers and leaders, as well.

Benner and Dreyfus teach us that when we are either novices or advanced beginners, we need:
• The direction of others more experienced than we are
• The opportunity to observe and receive support from good role models
• Understanding regarding the “state” we are in. That is, as novices, much of our focus may be on ourselves and how we are performing in addition to the outcomes we are achieving. ..."

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The article begins:

"If I were to ask you to rate your ability to inspire a shared vision with your team, what would you say? ..."

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The article begins:

"One reader is a manager who wants to change her unit’s culture, but she is encountering stubborn resistance. Another has a vocal employee who is negatively influencing others. The third reader wants to inspire nurses to become reengaged.

What do these Coaching Forum readers have in common? Each has the chance to develop rapport and renewed commitment with those who are resisting. ..."

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The article begins:

"It never fails. When I teach aspiring nurse leaders about leadership and coaching, no matter what the setting, there are charge nurses and managers who say they don’t want their supervisors’ positions. What about you? Does anyone want your job?

Of course, leadership roles are not for everyone. Still, there are too many qualified nurses who are reluctant to pursue leadership roles. How do we address this issue? ..."

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The article begins:

"Think back to a time when you were faced with a significant leadership challenge. It does not matter whether anyone else would consider this a crucial event. What does matter is how you experienced this moment in your life.

What comes to mind? Now, consider this question: What important leadership lesson did this experience teach you?... "

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The article begins:

"As the worlds of health care, nursing, and leadership become more complex and demanding, what does it take to be a successful leader? What does it really take to achieve professional goals and personal effectiveness while living a balanced and authentic life? Is it even possible?

Yes! But there is also no doubt that the requirements of leadership have never been more rigorous. Are you up to the task?... "

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