About the Book

Leadership in Nursing Practice, Second Edition is an essential text that emphasizes the leadership role of the nurse in day-to-day practice. The healthcare environment is rapidly changing, making it imperative that today’s nurse has the skills and knowledge to help lead the reinvention of health care. This text distinguishes leadership from management and helps prepare students to become leaders in their workplace.

The Second Edition is anchored in a sense of nursing as a professional practice discipline and engages the reader in discussions about teamwork, leadership, staffing, and a variety of other related topics. The text serves as a bridge between the student and the leader by providing theory and evidence for real-world scenarios that students can immediately put into practice. Unlike other leadership and management texts, the authors emphasize the importance of every nurse as a leader.

About the Author

Tim Porter-O’Grady, DM, EdD, ScD, APRN, FAAN, FACCWSSenior Partner, Tim Porter-O’Grady Associates, Inc., Atlanta, Georgia, Professor of Practice, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, Clinical Professor, Leadership Scholar, Ohio State University College of Nursing, Columbus, Ohio Dr. Tim Porter-O’Grady has been involved in health care for 44 years and has held roles from staff nurse to senior executive in a variety of health care settings. Tim is currently senior partner of an international healthcare consulting firm in Atlanta specializing in health futures, organizational innovation, conflict and change, as well as complex health service delivery models. He is noted for his work on shared governance models, clinical leadership, conflict, innovation, complex systems, and health futures. As associate professor and leadership scholar at Arizona State University, College of Nursing and Health Innovation, he has co-lead the implementation of the new Masters, PhD and DNP tracks in Health Innovation; He is also Clinical Professor and Leadership Scholar at the Ohio State University College of Nursing and is a member of the Dean’s Advisory Board and an adjunct professor at Emory University, School Nursing, Atlanta, GA. Dr. Porter-O’Grady holds graduate degrees in clinical leadership, 2 earned doctorates; one in learning behavior and a second in organizational and systems leadership. In addition, he received a Doctor of Science degree,honoris causa, from the Medical University of Ohio. He is mulit-board certified as a nurse executive; and advanced practitioner (APRN-CNS) in gerontology, and as a wound specialist. Tim is also certified by the Georgia Supreme Court’s Office of Dispute Resolution as a registered mediator and arbitrator. He is a Fellow in the American Academy of Nursing and is a clinical Fellow in the American College of Clinical Wound Specialists. Tim has published extensively in health care with over 175 professional journal articles and 22 books and is an 8-time winner of the AJN Healthcare Book of the Year Award. He has consulted internationally with over 600 institutions and has lectured in over 1200 settings internationally. He has held a number of offices in professional associations and national and community boards such as the vice chair of the governing board of both Catholic Health East and the American Nurses Foundation, governor with Sigma Theta Tau International, president of AID Atlanta, and the STT International Foundation, just to name a few. Among a number of honors, Tim has been recognized by American Organization of Nurse Executives with their Lifetime Achievement Award and by the American Nurses Association with the Luther Christman. Award. Kathy Malloch, PhD, MBA, RN, FAAN- Professor of Practice, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, Clinical Professor, Ohio State University College of Nursing, Columbus, Ohio, Clinical Consultant, API Healthcare Inc., Hartford, Wisconsin Dr. Kathy Malloch is a recognized expert in leadership and the development of effective evidence-based processes and systems for patient care. Her uncanny focus on accountability and results is the hallmark of her practice. Her expertise has been useful to many organizations across the country. A nationally known writer and speaker, Dr. Malloch has been a registered nurse for over 40 years. Kathy has published extensively in proctored health journals. She is a frequent presenter and author on leadership and innovation topics, healing environments, professional nursing practice, and patient classification systems. Most recently, Dr. Malloch has served as the first program director for the Arizona State University, College of Nursing and Health Innovation, Master’s in Healthcare Innovation program. This innovative, multidisciplinary program is the first of its kind in the country. She continues to teach in the leadership of innovation track in the nursing doctoral program at Arizona State University. Kathy is the designer of the Expert Nurse Estimation Patient Classification System (ENEPCS), an innovative model to integrate the role of the professional nurse in daily nurse-patient staffing to achieve the best outcomes. In 2008, ENEPCS was purchased by API Healthcare and is now integrated into their suite of staffing, scheduling, time and attendance, and business analytics products. Dr. Malloch is a graduate of Wayne State University, College of Nursing, received an MBA from Oakland University and a PhD in nursing from the University of Colorado. She is a fellow in the American Academy of Nursing. Currently Dr. Malloch serves as: Past-President of the Arizona State Board of Nursing Professor of Practice, Arizona State University, College of Nursing and Health Innovation Clinical Professor, Ohio State University, College of Nursing Clinical Consultant, API Healthcare, Inc. Hartford, Wisconsin Senior Consultant for Tim Porter-O’Grady Associates

Table of Contents:
Foreword • Preface • Acknowledgments • Reviewers Chapter 1: Change and Innovation • Dynamics of Change and Innovation • Who, Why, When, and How of Change • Strategies to Minimize Risk in Change and Innovation Scenarios • Making Change and Innovation Happen • Caveat: Technology, Change, and the Human Element • Caveat: Measuring the Impact of Change and Innovation (What Problem Are You Fixing?) • Managing Resistance to Change • Course Correction • Leading and Managing • Appendix A: Change Considerations: Scanning, Reflecting, and Integrating Chapter 2: Becoming a Professional Nurse • The Elements of a Profession • The Ethical Foundations of a Profession • Shared Governance and Creation of a Professional lnfrastructure • The Use of Language Characterizing Professional Dialogue • Personal Presentation of the Professional Self • Interactions with Other Disciplines • The Public and Policy Role of the Nursing Profession • Nursing and Transdisciplinary Partnership • I Am the Profession • Appendix A: Extinguishing Childlike Behaviors in the Professional Nursing Staff • Appendix B: The Professional Is a Cocreator Chapter 3: Person of the Leader: The Capacity to Lead • Self- Knowledge • The Continuous Journey of Becoming • The Leadership Mirror • Leaders Versus Managers • The Personal Attributes of Leaders • Courage and Leadership • Leaders Engage Stakeholders • The Leader Stays in the Question • Recognizing Personal Needs for Self- Development • Personal Transparency and Openness • Appendix A: Old Versus New Leadership Skills • Appendix B: Checking off Basic Leadership Attributes • Appendix C: More Leader Core Behaviors • Appendix D: What Staff Want from Their Leader • Appendix E: Leadership Chapter 4: Conflict Skills for Clinical Leaders • The Early Engagement of Conflict • Looking for the Signs • Personal Comfort with Conflict • Trust: Creating a Safe Space for Positive Conflict • The Need for a Just Environment • Fully Sharing Information • Alienation Between Colleagues: What Happens When It Is Allowed to Flourish • Overcoming Personal Barriers to Engaging Conflict • Handling Conflict • The Norm of Conflict • Appendix A: A Brief Conflict Skills Assessment Chapter 5: Staffing, Scheduling, and Patient Care Assignments: Models, Components, and Measures of Effectiveness • The Foundation: Patient Care Delivery Model • Identifying Patient Care Needs • Measuring Human Work • Patient Classification Systems: Limitations and Challenges • Core Schedule • Evaluation of Workforce Management • Leading Versus Managing in Staffing and Scheduling: Concluding Thoughts • Appendix A: Selected Staffing Effectiveness Research Evidence • Appendix B: Perfect Staffing Chapter 6: Principles of Ethical Decision Making • The Basics • Ethical Issues and Challenges • Strategies to Address Ethical Issues • Concluding Thoughts • Ethics Discussion Scenarios • Appendix A: Selected Healthcare Ethics Resources • Appendix B: Common Barriers to Effective Relationships Chapter 7: Leadership: The Foundation of Practice Partnership • The Importance of Teams in Interdisciplinary Practice • Team Construction • Team Fables • Team Progress • When the Problem Is a Team Member • Collaboration • Decisions • Creating Equity: Overcoming the Uneven Table • Interdisciplinary Alignment • Focus on the Team Leader • Virtuality and Team Performance • Concluding Thoughts • Appendix A: Sample Techniques for Team Decision Making • Appendix B: Team-Based Decision-Making Process • Appendix C: Keeping the Team Focused • Appendix D: Some Dos and Don’ts of Team Leadership • Appendix E: Creating Team Infrastructure • Appendix F: Considerations for Team Effectiveness Chapter 8: Resources for Healthcare Excellence • Basic Economics Are Not So Basic: Price, Demand, and Supply Complexities • Resource Categories: Human, Fiscal, Material, Technology, and Time • Value Measurement: Productivity, Quality and Volume • Basics of Budgeting • Dashboards and Measures • Variance Management • Concluding Thoughts: The Role of the Clinical Nurse Leader in Resource Management • Appendix A: Common Financial Reports • Appendix B: Staffing Effectiveness: Scorecard • Appendix C: Evolving Metrics Chapter 9: Navigating the Care Network: Creating the Context for Professional Practice • Complex Adaptive Systems • Placing Power Where the Action Is • Understanding How Clinical Work Changes • Transforming the Nature of Clinical Work • >From a Medical Model to a Health Model • Ending Medical Separatism • Value-Driven Health Care • Elements of a New Kind of Structure • The Premises of Professional Shared Governance in Health Care • The Individual and the Organization • Appendix A: Shared Decision - Making Requisites • Appendix B: Shared Governance Staff Assessment Instrument • Appendix C: Survey of Shared Leadership Practices Chapter 10: Managing Your Career: A Lifetime of Opportunities and Obligations • Transition to Practice • Career Trajectories • Interviewing for New Roles • Continuing Competence • Course Correction: Life After Discipline • Excellence Versus Perfection • Personal Balance and Health • Exercise, Nutrition, and Role Modeling • Contributing to the Profession • Additional Thoughts • Appendix A: Writing for Publication Chapter 11: Policy, Legislation, Licensing, and Professional Nurse Roles • Key Concepts • The Policy Continuum: Local to National • Contemporary Healthcare Policy Issues and Initiatives • Professional Nursing Role and Policy • Final Thoughts on Policy • Appendix A: Selected Resources for Healthcare Policy Chapter 12: Delegation and Supervision: Essential Foundations for Practice • Delegation: Definitions and Key Concepts • Steps of the Delegation Process: Roles of the Delegator and the Delegate • Protecting Your License: Nursing Liability for Delegation • The Challenges of Delegation • Strategies to Support Effective Delegation • Final Thoughts • Appendix A: Joint Statement on Delegation: American Nurses Association and National Council of State Boards of Nursing • Appendix B: Delegation Assessment: Why Don’t I Willingly • Delegate or Accept Delegated Tasks? • Appendix C: Process of Delegation Chapter 13: Overcoming the Uneven Table: Negotiating the White Waters of the Profession • Principles and Basic Skills of Negotiating • Give and Take: The Principles of Exchange • Stages of Negotiation • The Clinical Leader and the Unique Characteristics of Collective Bargaining • Negotiating the Profession • Appendix A: Negotiation Skills Assessment Chapter 14: Accountability and Ownership: The Centerpiece of Professional Practice • The Professionalization of Nursing in the th Century: The Path to Accountability • Maturing the Profession: The Age of Accountability • Accountability and Ownership • The Cycle of Personal Accountability • Accountability in Action • Individual Role Accountability and Team Performance • Delineating Professional Work and Accountability • From Process to Outcome Focus • Accountability Is About Adding Value • The Individual, Creativity, and Accountability • Accountability and the Engagement of Risk • Accountability and Performance • Appendix A: Individual Role Accountability and Team Performance • Appendix B: Fitting Individual and Team Goals Together • Appendix C: Creating a Culture of Accountability • Appendix D: Revisiting Invitation and Expectation • Appendix E: Responsibility Versus Accountability • Appendix F: Accountability and Impact • Appendix G: Role Clarity and Accountability Model • Appendix H: Accountability and Locus of Control • Appendix I: Ownership: The Center of Accountability • Appendix J: Volume Versus Value • Appendix K: Some Risk-Dealing Rules of Engagement Chapter 15: Integrating Learning: Applying the Practices of Leadership • In the Era of Health Transformation • The Context of Healthcare Reform • The Management of Conflict • The Centrality of Accountability • Structure, Organizations, and Professionals: Creating the Context for Practice • Resource Management in Health Care • Ethical Behaviors • Staffing Effectiveness • Change and Innovation • Policy Making • Delegation • Career Management • Concluding Thoughts • Appendix A: Exercise in Leadership: Advancing Evidence-Based Practice • Appendix B: Exercise in Leadership: Increasing Capacity • Appendix C: Exercise in Leadership: Clinical Technology Management Glossary • Index