Thriving in a Political World
As we are bombarded daily with the upcoming presidential election candidates debates, "Thriving in a Political World" presents more than a challenge to nurse leaders and executives of healthcare systems. Who will truly be concerned with the major issues facing the healthcare crisis in our country? What are the hidden agendas, and is there a possible healthcare provision for all, regardless of economic status and political meaning? How do nurse leaders survive and even thrive in an environment embedded with political ramifications at every turn in the road?
If a nurse leader espouses patient care concerns requiring excellence in nursing practice seeking sufficient numbers of registered nurses to enable professional practice, the nurse leader is thought to be promoting self-interest and is viewed as self-effacing. Pocketbooks of healthcare systems remain the priority over patient well-being and best circumstances for meeting patient needs. It has become increasingly obvious that when a very strong patient and nurse advocate leader experiences a new chief executive officer, usually the nurse leader is deemed no longer politically fit for the organization, even though performance reviews indicate superior leadership of the patient care workforce.
"Thriving in a Political World" is exemplified by Kathleen Sanford, DBA, RN, FACHE, Senior Vice President, Chief Nursing Officer, Catholic Health Care Initiatives, who is the guest editor for this issue of Nursing Administration Quarterly. Kathy has more than 32 years' experience in healthcare, including staff nursing, middle management, chief nurse executive, and hospital administrator roles. A former army nurse, she retired as the chief nurse of Washington Army National Guard. She served as the 2006 President of the American Organization of Nurse Executives, and has been appointed to the American Hospital Association Long-Term Planning Committee for 2007.
Kathy has served in leadership positions for numerous community and charitable organizations and has been an adjunct faculty member for The University of Washington and Pacific Lutheran University. She currently writes a monthly column on healthcare business for Healthcare Financial Management Association's Business of Caring. As a former newspaper healthcare columnist and author for multiple publications, she has published more than 100 articles and the management book, Leading With Love. Research studies for her American College of Hospital Executives thesis and her doctoral dissertation were in the area of healthcare leadership.
Nurse leaders have learned through multiorganizational politics that we have to hang tough and support each other, rather than hang each other. Without specifying GOP and Democratic candidates for our upcoming presidential election, people have become disenchanted with the political arena of debate and discourse, which is lacking a potential to bridge the partisan gap. How do nurse leaders stay positive in such a negative political environment? What is at stake for the healthcare system and patient care? The public sees nursing as a profession of scruples and trust. But can we expect miracles for our future healthcare system? We are movers and shakers who rise above the vapid and opuscule minutia of dominating healthcare executives who do not support the best interest of patient care and professional nursing education and practice.
What we fail to accept and actualize is that we, as a profession, are very powerful. Power is the ability and willingness to influence the behavior of others. Although there is so much negative connotation in political power, when used appropriately, power is energy and strength in action. Our strength, as a profession, comes from an awareness of who we are. When we, as nurse leaders, know what we are about, and what we can offer, and we are unified in communicating our nursing mission and vision, then we have a strong self-concept with an awakening of reality and a recognition of our limitations and weaknesses.
Power can and should be shared in nursing when nurses are enabled to practice in an environment that supports them to maximize individual potential as a professional. Political structures and professional organizations need to be researched and studied to determine efficacy in sharing professional decision making affecting practice. Organizational climate often reveals how the mission and vision is optimized or impeded. In my early research and consultation work, distinctive differences were found in organizations studied using an organizational climate inventory, which I developed as my doctoral dissertation, and subsequently used as a consultant. So much time has passed, and reflectively, I see the same conflicts in organizations between administration, nursing staff, and physicians, but Magnet hospitals have made a great difference in the political climate of these practice settings. Now we need Magnet political influence for the future of healthcare survival and thriving in a new way.
Power, profit, politics, propaganda, and public mandate challenge nurse leaders to unite in political arenas at the state, national, and international levels. What kinds of skills are needed to impact political power in the delivery of healthcare and the practice of nursing? Powerful communication skills that minimize conflict and build collaboration in today's political environments at work, in our communities and organizations, in national and international settings, and in our daily lives. This is what makes connections with people everywhere. It is how we talk---and listen. It is how we establish trust with each other. It is how we gain respect and affection. It is how we live our lives and uphold our beliefs about the rights and dignity of others. It is being an exemplary nurse. I am so grateful for my more than 50 years in nursing and the gifts I have received from above to allow me the privilege of being a nurse.
Barbara J. Brown, EdD, RN, CNAA, FAAN, FNAP
Editor-in-Chief, Nursing Administration Quarterly