1. Raso, Rosanne RN, CNAA, MS

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Q It seems the more I give to my staff members, the more they expect. How can I better set limitations?


This is an interesting question since it presents the eternal dilemma of finding balance in our work, something many of us struggle with in leadership. According to the principles of servant leadership, we should be of service to our staff in order to encourage collaboration and trust. With this idea, we can lead our staff members through coaching, mentoring, and empowering them to perform optimally in a healthy practice environment. In this context, you can't do too much. Nonetheless, you shouldn't be called at 2 in the morning for everything, nor should you be asked to make scheduling changes that adversely or unfairly affect others. Helping with patient care to get through a hectic day isn't an unreasonable expectation and gives you the opportunity to role model. However, don't allow "reverse delegation" unless it's really a call for help due to unclear expectations or being totally unable to do something. Help staff members to do things correctly once, and they should be able to perform the duty on their own next time. Be clear on your goals and expectations, be confident in their abilities, hold them accountable for requirements, teach and share constantly, and you'll enjoy your role as nurse leader without feeling abused.



Q As the CNO of a large healthcare system, I often have to give presentations to the board of trustees. They seem out of touch with what really goes on in the hospital. How can I best get them to understand without insulting them?


Be confident-you're the best person to educate them on patient care and nursing practice issues. The board is no different than other concerned constituencies. Approach it as you would any presentation to lay people-don't use medical language, keep the slides simple, use compelling data in visually appealing ways, tell stories, and use examples they can relate to as consumers. Have two or three key messages. Find a champion to help you raise awareness and become your partner in influencing their peers. There's little risk of insulting them when you speak knowledgeably and professionally, share important key messages about patient quality and safety, and make them proud of their nurse leader.