Taking steps to form partnerships

A workshop is like a partnership, and partnerships were indeed formed during a workshop I presented recently in Cape Town to a group of 12 nursing service managers. Throughout, the underlying dynamics of collaboration and shared leadership were emphasized and enforced.

Designed to develop dialogue between partners by pushing them beyond their comfort zone and challenging their thinking, the workshop exposed these health practitioners to a variety of new legislative measures related to health care delivery and required them to explore differences in the legislation through questioning, prodding and reflecting upon underlying principles. It was an environment that involved voluntary cooperation and commitment.

Workshop participants

As equal partners in the process, the workshop participants felt free to openly air their views. As a result, members shared information, creative ideas and solutions that applied in their work settings that, inter alia, included the specialities of psychiatric nursing, infection control and forensic nursing in healthcare settings of various sizes.

In the various sessions, all participants took an active role in sharing their unique qualities and work responsibilities and how they were professionally accountable in practice. This further enhanced a sense of partnership in identifying shared problems and helped foster suggestions for problem-solving strategies.

Throughout the workshop, participants drew upon previous experiences and personal reflection to coach each other. The opportunity to use past experiences as resources was essential and led to the development of a united team. By valuing the motivational needs of the group and their contributions as partners in health care delivery, all participants felt empowered to accept responsibility for transformation in their health care organisations. The coordination of information between different hospitals and services will lead to future collaboration among participants.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

A passion for nature and nursing

From early childhood, I have had a passion for being in nature. Two weekends ago, I traveled approximately five hours north of Cape Town, South Africa to view flowers in Namakwaland. It is a land of contrasts where dry lands are transformed into collages of bright colors. It is believed that 4,000 or so different species of plant seeds are involved. Every year between July and October —South Africa’s spring—brings a different formula and a different selection of flowers.

The flowers of Namakwaland

While driving through this paradise of flowers, I thought of a presentation I had made the preceding week at a graduation ceremony at Cape Town University of Technology, in which I spoke about developing and retaining passion for nursing. Although Namakwaland is semidesert, it transforms into a spectacular view. Likewise, student nurses, despite many challenges, eventually complete their courses and develop a passion for nursing that enables them to focus on the overall outcome of “health for all.”

A journey through Namakwaland usually takes at least three days. As we viewed the beautiful landscapes, I experienced a close relationship with my surroundings that felt warm, friendly and close to my heart. It was as if the spring flowers were serving me by allowing me the privilege of looking at them and enjoying their beauty, thereby uplifting my spirit and improving my overall well-being.

In caring for human beings, who are holistic, nurses, like the spring flowers of Namakwaland, render, on a 24-hour basis, the most intimate personal service to their patients, thereby uplifting their spirits and contributing to their well-being. Patients are different in so many ways and, from admission to discharge, nurses holistically respond to those varied needs.

One’s passions derive from decisions to pursue goals that are personally meaningful, and my two-day journey through Namakwaland, with its magnificent and majestic floral displays, gave me new energies to tackle my work. When we depend only on rewards, such as compensation and security, we lose sight of who we really are. We must take advantage of opportunities we are given to uncover meaning in our work and personal lives.

The seeds of Namakwaland flowers have the ability to lie dormant for a number of seasons, awaiting conditions suitable for germination. As nurses, we should not wait to take the lead in the workplace. By focusing on the right things that bring you joy in the workplace and in your personal life, you become a colorful flower in the lives of everyone around you.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Shared leadership via a unified teaching platform: Some questions

In South Africa, the Department of Education determines what undergraduate and postgraduate nursing programs higher education institutions should offer. Higher-education nursing schools all enroll postgraduate students, while some enroll both undergraduate students, in large numbers, as well as postgraduate students.

I serve on the School of Nursing faculty at the University of the Western Cape in South Africa. In the Western Cape, a regional integrated framework exists among nursing schools for a common shared teaching platform at the undergraduate level. Drawing upon the expertise and facilities of five higher education institutions in the region, the framework’s shared leadership is regarded as distributed leadership. An academic board representing the institutions governs the process and reports, via the Council for Higher Education Committee, to relevant committees at those institutions.

The purpose of shared leadership is to use skills and knowledge to create a common culture of expectations. In the process, no institution should give up its autonomy or power. In this environment, the challenge is to establish productive relationships and to be accountable for contributions made to a collective result.

Some probing is needed, however, to determine if common-platform teaching aligns with the principles of equal distribution (shared) leadership. Here are some principles, together with questions (in italics) that need to be asked:

For this model of leadership to work, there must be equal partners. In the shared-teaching platform, the offering institutions are to follow the enrolling institution’s teaching framework. Which institution—offering or enrolling—should have responsibility for designing the course outline?

Shared leadership is practiced in a supportive work environment, which is dependent on dynamic alignment. Who appoints staff members to teach on a common shared-teaching platform?

Shared leadership works when all participants share responsibility and are accountable for the work of the partnership. What are the responsibilities of the offering and enrolling institutions?

Each person in the group brings with them skills and ideas that are valuable. It is important, therefore, that differences within the group be recognized and embraced. Which theoretical framework or approach should be used in teaching?

Team-building, conflict management and ability to build a new culture are among the necessary skills needed for the success of shared leadership. What happens when students experience problems with a lecturer from a participating institution? What if lecturers are not in agreement on the assessment process? What if there are contradictory policies among institutions with regard to assessment?

Partnering in real-life situations implies collaboratively working smarter, not harder. What happens if the workload is not equally distributed?

Shared leadership focuses on having a shared organisational identity. Do offering institutions submit the list of examiners to the enrolling institution for appointment?

A great deal of individual autonomy is emphasized through the concept of shared leadership. Can offering institutions utilize their own venues for conducting examinations?

An agreed-upon common purpose is extremely vital for the mutually supportive elements of shared leadership. Among educational institutions, what is the main common purpose of a shared teaching platform? Does shared leadership, at the end of the day, enhance quality teaching, promote collaborative research and increase student output?

Through shared leadership, the burden of stress, the complexity of the issues and the urgency for better decisions should be distributed among a team of leaders and institutions. What should be the next step?

Reference:

Jooste, K. (2010). Leadership in healthcare services (2nd ed.) Juta Kenwyn. 

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Self-leadership for youth

The youth are the future of a country, and promoting their health should be a key objective of primary health care clinics. In our communities, the young are prone to injuries and trauma—minor to extensive—that are related to aggression, drug abuse, fights and car accidents. These injuries can have a crippling effect not only on the person sustaining the trauma, but also on the person’s parents and community.

For the traumatized person to be restored to normalcy and take up his or her role in the community, severe injuries, whether psychological or physical, require rehabilitation. To support that rehabilitation, self-leadership programs in primary health care clinics are helpful.

Self-leadership is a lifelong personal journey, one that further develops a young person’s strong qualities while addressing his or her weaknesses. For this journey to be initiated properly among youth, evidence of the trauma they’ve encountered is needed. A nationally funded research project that could lead to a community engagement program for youth is currently underway in Clinics Johannesburg in South Africa.

Although there is relatively little data available on the prevalence of youth exposure to violence and trauma in South Africa, a few surveys have described that exposure and its associated psychological outcomes. One study indicated that both full-symptom post-traumatic stress disorder (PTSD) and partial-symptom PTSD are significantly higher in South Africa than in Kenya: 22.2 percent versus 5 percent for full-symptom PTSD and 12 percent versus 8 percent for partial.

A South African survey by Ward, Flisher, and Zissis (2001) of 104 adolescents in four secondary schools in Cape Town found that the majority of youth were exposed to at least one type of violent event, either as a victim or as a witness (Seedat, Nyamai, Njenga, Vythilingum, & Stein, 2004). The survey also found that youth from those schools were exposed to a high level of violence and trauma in their neighborhoods and homes, as well as in school. While many teenagers have been victims of violence or extreme trauma, many more have seen or witnessed these events (SAHealthInfo, 2004). If support is not provided to these young people, the results of their trauma can continue into adulthood. Similar situations of youth trauma are found in the Johannesburg region. The need for a program that supports youth in dealing with trauma is thus evident.

As a principal investigator of a research project on youth violence, I conducted interviews with youth and their parents and realized that we have a “Somalia” in our communities. There are people without food to eat! As they shared their stories with me, I learned that their lives are a sequence of traumatic incidents, and it was amazing to hear how they deal with their challenges.

Is it possible for a community to heal? The people I interviewed gave me hope that, despite unhealthy circumstances, it is possible to do something for one’s self. By helping others, these people have helped themselves move forward through their hurt. It’s like a process of regeneration. Despite multiple traumatic events, faith keeps them standing. In the absence of hope, faith seems to give them a reason to live.

While conducting my interviews, I reflected a lot on myself, where I am and the impact that this research has had on me personally. People need somebody to listen to their stories. There is a huge need for help, and the need sometimes can be overwhelming in terms of what you think you can do as an individual.

All successful actions start with a good self-image, especially among the youth. Therefore, it is important that they learn to craft a self-image capable of sustained acts of greatness. Preparation, conditioning, persuasion and training precede leadership actions. Self-leadership is the process of influencing yourself to establish the self-direction and self-motivation needed for effective performance or to accomplish desirable outcomes (Politis 2006).

References:

Politis, J.D. (2006). Self-leadership behavioural-focused strategies and team performance. Leadership and Organization Development Journal, 27(3), 203-216.

SAHealthInfo. (n.d.). Bathuthuzele youth stress clinic. Retrieved from http://www.sahealthinfo.org/mentalhealth/bathuthuzele.htm

Seedat, S., Nyamai, C., Njenga, F., Vythilingum, B., & Stein, D.J. (2004). Trauma exposure and post-traumatic stress symptoms in urban African schools. The British Journal of Psychiatry, 184,169-175.

Ward, C.L., Flisher, A.J., & Zissis, C. (2001). Exposure to violence and its relationship to psychopathology in adolescents. Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention, 7, 297-301.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The agenda

I was sitting in a high-profile meeting, looking at the agenda, when I realized I was in the right place at the wrong time. Or should I say the right time in the wrong place? With its never-ending, nonstop demands to improve, the place I’m referring to felt like a roller coaster. Or was it a new type of management syndrome that had come over us? It was like stepping into a marketplace where everyone wants to sell a bigger and better idea, and become famous. Or was I watching a movie?

Some of the latest concepts and terms were included in the vision and value statements we were considering: excellence, integrative, quality, culture, caring, competence, accountability, responsiveness, integrity and value-based. The words were academically sound, but the challenge was to develop another strategy to build the image of nursing around the world. While still contemplating nursing’s global image, my thoughts jumped to the strategies that were being discussed with regard to nursing agencies and specialties.

How do you sustain competencies of nurses in an environment where Continuous Professional Development (CPD) is not yet a legal requirement? The answer, naturally, has become: Design a new plan, but not just an informal or in-service training program. I remembered that a comprehensive service plan, occupation-specific dispensation plan and annual performance-level plan were already in place, but I suddenly could not recall what the comprehensive service plan was all about.

Staffing is always a standing item on an agenda, and answers were sought with regard to the huge number of retiring nurses, available posts, creating new posts, norms and standards for staff members versus patients, orientation and induction policies, mentoring and coaching programs, succession planning and continuous development of all categories of nurses. Need I continue with the list?

It appeared that new committees had to be established. Listed on the agenda for the next meeting were nominating procedures for the terms-of-reference committee, adjudication committee and succession-planning committee.

Suddenly, I got tired of keeping the minutes.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Nurses in South Africa observe National Women’s Day

In South Africa, the 9th of August is National Women’s Day (not to be confused with International Women’s Day, observed 8 March). It commemorates 9 August 1956, when women participated in a national march to petition against “pass laws,” legislation that required non-whites to carry a document to “prove” they were allowed to enter a “white area.” A protest song composed in honour of the occasion declared, “Wathint’ abafazi, wathint’ imbokodo!” Translated, “You strike a woman, you strike a rock!” (This has nothing to do with nurses that strike!)

National Women’s Day celebrates women’s courage and strength. Similarly, nurses are viewed as the backbone of health care delivery systems. On this day, nurses should reflect on what they have accomplished and what else they must do to ensure health for all in the community and in their own lives.

One week before National Women’s Day, nurses in South Africa celebrated at the 2011 Annual Nursing Education Conference at Sun City (see previous post). You will never believe it—Karen Morin, the president of the Honor Society of Nursing, Sigma Theta Tau International (STTI), was a keynote speaker! The conference alerted nurse educators to changes implicit in national and international trends, legislation and agendas. Through debate, competence building and information, they were also introduced to changes they are facing in their own educational practice. Workshops were offered, one of which focused on scientific writing for beginners. This session was attended by STTI President Morin and Address Malata of Malawi, president of STTI’s Tau Lambda at Large Chapter.

Nurse leaders at the Annual Nursing Education Conference in Sun City

included: (front, l-r) Christa van der Walt, RN, RM, RNE, RNA, RCN,

University of the North West; Karen Morin, DSN, RN, ANEF, president

of STTI; Address Malata, MScN, PhD, president of Tau Lambda at

Large Chapter; and (back) Karien Jooste, MA Cur, DLitt, RGN, RCN, RM,

RNE, RNA, University of the Western Cape; and Gisela van Rensburg,

MA Cur, University of South Africa.

Nursing students take National Women’s Day in South Africa very seriously. The Nursing, Social Work and Natural Medicine students at the University of the Western Cape held their annual Women’s Day event in Grabouw (near Cape Town), also on 9 August. Last year was the first time that nursing students initiated this event, and the community decided it must take place annually. (See poster and brochure below.)

Worldwide, nurses (mostly women) are becoming more involved in the political arena to influence national health agendas. (I have also observed the trend of more males entering the nursing profession in South Africa.) Although partaking in top-level matters is very important, we should not lose the soul of our profession. Till the next National Women’s Day, we should continue to impact positively the lives of the community, in which a number of challenges still remain. Let’s focus on attitudes and practices that could manifest themselves positively, particularly for women.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Catching the next wave

From 1-4 August, nurses in Africa will be stepping into the Valley of the Waves and focusing on the theme of Change!, as they attend the Annual Nursing Education Conference at Sun City in South Africa’s North West Province. The event will have a unique heartbeat and an African rhythm of its own. Only 187 kilometers from Johannesburg, Sun City is situated deep in the rugged Bushveld, a subtropical woodland nestled in the heart of an ancient volcano and surrounded by the imposing mountains of the Pilanesberg Game Reserve and National Park.

Sun City in North West Province, South Africa

The conference is a collaborative effort of the Forum of University Nursing Deans in South Africa (FUNDISA), the Nursing Education Association (NEA) and the Tau Lambda-at-Large Chapter of the Honor Society of Nursing, Sigma Theta Tau International (STTI). Founded in 2001 as the African Honor Society for Nurses, the Tau Lambda-at-Large Chapter was established to connect nurses of Africa with STTI, and a decade has passed since African nurses began to join the honor society.

Catching the waves at Sun City

A leadership-initiative workshop related to the theme of Change! is scheduled for the second day of the conference to challenge fellow nurses from various countries in Africa. In thinking about the workshop, I reflected on the concepts of leadership and change in nursing. During change, it could be that we will move between leadership perspectives—that we should leave a perspective with which we are acquainted and move toward a new perspective appearing on the horizon. Does this happen when changing one leadership position for another?

When we move in a new direction, the most fundamental tenets of what we believe and value are often challenged, and may even change to a certain extent. Conversely, some elements of our former perspectives of leadership remain and continue to guide our actions. We can never cut all ties with a previous perspective in favour of a new one. Or could we? One thing I am convinced of is, different times and waves demand different leadership approaches. Which wave should I ride next?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Join the nurses of South Africa in celebrating Mandela Day

Sometimes, a step taken by one person can directly influence the destiny of many others. In South Africa, this happened when Nelson Mandela stepped from Robben Island, where he had been incarcerated for many years for anti-apartheid activism, into the eventual leadership of a new, multiracial democracy. He spent more than 67 years serving his community, his country and the world at large.

Nelson Mandela

In recognition of his contributions, Mandela Day was inaugurated in 2009 on Nelson Mandela’s birthday. Today—Monday, 18 July—he is 93. Mandela Day is a call to action for people everywhere to take responsibility for making the world a better place—one step at a time—just as Mandela did. It’s also a call to every nurse to be accountable for their responsibilities, to make the environment in which they practice—clinical, educational, management or research—a customer-friendly and focused environment.

We should believe that we can change the world of nursing to make it a better place—a better place not only for the patient or client, but also for ourselves. The decision to make a difference by making changes in our own internal and external environments starts with ourselves, and it can start today. Today, you can make a creative change in your daily routine that will have positive results. Why not take 67 seconds of your workday—one second for each year that Nelson Mandela spent in service to his community—and devote that time contributing to the happiness of others around you?

It’s a small gesture to show our solidarity with humanity. It’s about going that extra mile—or smile. Madiba, as Mandela is known to many, loves the children of Africa, so why not take 67 seconds to do something special for a child? Can you devote 1 minute and 7 seconds of your time to celebrate the theme of Mandela Day with the nurses of South Africa? It would be a small step toward a continuous, global movement for good in nursing.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.