HealthDecember 21, 2023

Confidence building skills training is critical for nursing leadership

Senior Clinical Editor Lisa Bonsall discusses the link between confidence and nursing leadership with expert Carol Huston.

One of the dominant characteristics of any leader is self-confidence, a quality that is especially beneficial for nurses who often find themselves in leadership positions during their careers. In this video interview, Senior Clinical Editor Lisa Bonsall, MSN, RN, CRNP, CCRN-K, discusses the importance of confidence skill training to develop more nurse leaders with Carol Huston, MSN, MPA, DPA, FAAN, who presented, “Why Leadership and Innovation are Hard,” at the Lippincott® Nursing Education Innovation Summit earlier this year.

An international nursing leader, motivational speaker, and nursing educator, Huston has authored several books that explore the leadership role of nurses in influencing healthcare innovation, including, The Road to Positive Work Cultures, and its companion piece, The Road to Leadership. In her Summit presentation, she called leadership “a critical skill for all nurses, but an especially daunting task for faculty in nursing programs.” Breaking it down, she identified four key aspects of leadership: Guiding, Directing, Influencing, and Transforming, all of which require confidence to be an effective leader.

Huston stressed in her presentation that critical decision-making is often imperfect, further underscoring the need for quality decision-making skills, especially when confronting what she called “wicked problems,” which typically are difficult to define, have interdependencies, and are multi-causal. In these cases, solutions can lead to unforeseen consequences, have no clear solution, and may be socially complex, involving changing behavior. In these cases, nurse leaders often find themselves sitting astride organizational boundaries and responsibilities, with “wicked problems” being seemingly intractable with chronic policy failure.

Huston explains to Bonsall that much of today’s “wicked problems” are due to changes that have occurred in healthcare over the past two decades, which she calls “absolutely monumental.” Because nurses often find themselves as part of a team, and even leading teams whether by choice or assignment, she says they must “know and understand innovation because they are part of a team that's going to be initiating and carrying out change.”

Adds Huston, “The role of innovation on critical thinking, problem-solving, and decision-making skills is absolutely critical to nursing success.” This includes gathering and analyzing data to determine if something is culturally relevant, weighing alternatives, and critically evaluating which alternative has the greatest likelihood for success.

“If you're going to be a change agent and lead a plan for change, you have to be able to make decisions. You also have to learn how to elicit knowledge and expertise from others who may have a different skill set than yourself. There's absolutely no way to separate decision-making from the skill set to be a nurse leader,” she emphasizes.

Bonsall asks Huston to weigh in on the role of innovation in nursing leadership, with Huston calling it “the umbrella for nursing innovation.” She clarifies that “Many nurses lack confidence in their ability to lead others,” saying, “If you're not confident or you don't see yourself as a leader, it's very hard to take risks not only to bring forth ideas but also to carry them out.”

In her Summit presentation, Huston challenged nurse educators to ask themselves a fundamental question: “What is your risk quotient in decision-making?” She added, “Change agents must be patient and open to new opportunities, as complex change takes time and multiple attempts may be needed before desired outcomes are achieved.” She emphasized that changes should never be attempted unless the change agent can make a commitment to be available until the change is complete. Faulty data gathering, incomplete information, and misleading context all can negatively impact the process.

Given the risks associated with leadership, Bonsall asks, “How confident do you think nurses are with their leadership skills?” Huston’s frank response is akin to a wake-up call. “I actually think we have a crisis in terms of nurses’ confidence about their leadership skills. As I've traveled the world, one of the constants that I hear is many nurses feel they're unprepared for the leadership positions that they currently hold. Sometimes it's because they've not had any formal leadership training, she asserts. “Other nurses have had leadership training, but they didn't really pay attention because they didn't think it pertained to them, or they didn't realize how quickly they were going to be asked to assume leadership positions. And far too often, nurses lack confidence in leadership because it's just not a role that they actually thought they would ever assume. It's something that they had to step up to because there was no one else to fill that job.

“Fortunately, most nurses have far greater leadership skills than they give themselves credit for,” Huston stresses, even if they “had to learn those skills the hard way, through trial and error.” She added in her Summit presentation that it is important to practice self-care when called to lead because “giving to and doing for others can be self-depleting.” On the leadership journey, Huston encourages nurse leaders to “slow down when you need to, determine what you want your leadership journey to be, and be confident in who you are as a leader.”

Watch Lisa Bonsall from Wolters Kluwer conduct the video interview with Carol Huston.

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