For nurse leaders in South Africa, back to basics includes writing for publication

Irrespective of your seniority or what stage you’re at in your academic career, getting back to basics is essential. In South Africa, that includes going back to the basics of writing for publication, because the benefits are both individual and institutional.

So, when nurse leaders in my country gathered outside Pretoria the week of 4 March, one of their priorities was to learn more about writing for publication. Leading the workshop was Hester Klopper, president-elect of the Honor Society of Nursing, Sigma Theta Tau International (STTI).

STTI President-Elect Hester Klopper conducts writing for
publication seminar near Pretoria, South Africa.

To obtain financial subsidy for tertiary academic institution in South Africa, academicians must publish in accredited journals. A list of qualifying journals for which subsidies are allocated is published by South Africa's Department of Higher Education & Training. Moreover, to achieve National Research Foundation status, nurse leaders must focus their writing on a specific niche.

I would like to know if other countries have similar systems in place. I welcome your comments.

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

Nurse educators take lead in leadership research programme

I am part of a new journey in establishing a leadership development research programme within the context of a university. Its aim? To establish one of the niche areas of the School of Nursing at the University of the Western Cape. Over the last few years, the focus on leadership development has surfaced in many national health care documents. However, few research-based studies have been implemented in the public health care sector of South Africa. It was decided that self-leadership in professionalism would be the focus of our proposal.

A group of eight nursing lecturers gathered in Franshoek, near Cape Town, where we worked on developing a broad framework for the programme and establishing objectives. It was quite a challenge for so large a group to work together in writing one proposal. Apart from that, it was cold, with snow on the mountains around us—not a common phenomenon in Africa. But, what made the writing retreat a great success was the enthusiasm and commitment members showed in writing a proposal that could benefit the community of nurses in the Western Cape.

The Franshoek collaborators

Writing the proposal was, in itself, an opportunity to develop self-leadership. It served as a tool for helping individual participants think about their own self-leadership, in practice. Group discussions led to the realization that self-leadership expands one’s capacity to be effective, both in leadership roles and processes.

It was wonderful to observe how, in the process of developing a leadership research programme, participants assumed leadership roles and worked together in a productive and meaningful way.

Now, the next step—getting funding for the project!

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

Leading from home

Over the last couple of weeks, I have been thinking about a career option that is becoming more common in South African universities, that of “home professor.” It is not an option I would have previously considered, but one I temporarily adopted during my recuperation from surgery.

I have had to adapt to a different situation and environment—staying at home and being constrained to the comfort of my bedroom. It has been a challenge, as I was well acquainted with my normal work environment, but my new situation required me to move my leadership style toward self-leadership, at home.

I know all people are not the same, but academics do have much in common. Nurses as academics are so used to working any time of the day that they, perhaps, have an understanding that you do whatever it takes! Or, maybe it is my generation? Anyway, as I lay in bed, it did not take me long to start thinking about my students and the backlog that was probably building up at work and, before long, I was back on my computer.

Working from home requires adaptation. Recently, I realised I was looking through my own mental window and, therefore, may have failed to notice other views. 

Slowly, my days began to fall into a certain routine. I enjoyed seeing my husband more often and listening to the sound of the sea. (I am fortunate to stay at both lake and sea.) While working on documents, I developed certain thought patterns and realised that I needed to interface with others on some aspects. It is known that, to attain goals, leadership involves change that requires interaction with colleagues. One could argue that the latest technology is available for that purpose, but for me, in light of the way I express myself, technology didn’t fully meet my needs for direct communication. I did find, however, that my output was amazing!

To avoid being blinded by their own perspectives and experiences, leaders need to continually assess themselves, recognise changing circumstances and adapt accordingly. Leadership involves influential relationships among people, but working from home required me to use my own influence and power to move forward.

Luckily, one can move from one leadership style to another, depending on the situation. As return to my normal work environment slowly appears on the horizon, I am now ready to leave behind the self-leadership pattern I adopted during my home stay, and I see myself moving back to team leadership. If you have the opportunity to work from home, do not become over-confident and thus overestimate how much you know about your field of interest and what is going on in the working environment.

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

Changing to a new, multicultural environment

Taking a step to change your workplace at age 50 is not an easy thing. For me, however, it was a conscious decision and non-negotiable. South Africa’s Gauteng Province, where I moved from—I came from Pretoria—is a rat race. The Cape, where I moved to, is seen by many as having a slow pace. I think everyone would wish for the latter!

Cape Town attracts people from many cultures, so I’ve found myself working with people from a culture different from my own, one that is entirely new and unfamiliar to me. Indeed, I found myself not only in a new workplace, but also part of the minority culture. It is neither uncomfortable nor a source of stress, and I have actually gained some insight into my own feelings and perceptions.

I’m finding that, by acquiring an understanding of my own cultural patterns and those of my colleagues, I am developing the ability to recognise and handle situations differently. As with any new workplace, it has brought different challenges, issues, policies and ways of doing things, and how I respond has to do with how I view it from “the outside.” Sometimes, I even enjoy the different ways in which my colleagues do things. At one stage in the process, I thought, I actually belong in this new culture. But then I posed a question that put it in a different perspective: Are nurses not all from one culture?

Maybe nurses are one culture working in a multicultural environment. In the context of health care delivery, we are seeking to meet the growing and diverse health care needs of people from diverse cultures worldwide. Or does this sound bizarre?

Well, all I know is, tomorrow is another step in the journey, and I will be welcomed in my workplace by nurse educators who also want to make a positive contribution to the educational development of students.

I believe I have the ability to work simultaneously in two cultures.

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

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.

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.