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Running head: NURSING PRACTICUM PAPER 1

Nursing Practicum Paper

Marie Wendt

Ferris State University

NURSING PRACTICUM PAPER 2

Abstract

Stepping into leadership positions as a new nursing administrator is challenging. A learning

practicum provides the nursing leadership student with a formal process for strengthening skills

which require developing. This practicum paper identifies the author’s deficiencies in nursing

administration skills and developed a structured learning practicum for developing them.

Through project development of a nurse manager orientation at a mid-Michigan hospital, the

author identifies activities which encourage the development of needed skills to accomplish the

deficit in four identified American Nursing Association (ANA) Scope & Standards for Nursing

Administrator competencies. Theoretical frameworks and evidence based literature was

reviewed to substantiate activities included in the learning plan. Preceptorship by an executive

nurse and structured evaluation using Bloom’s taxonomy were identified as key components to

assess success.

Keywords: Competency, development, leadership student, nursing administrator, nurse

leader, nurse manager, orientation, practicum, standards


Nursing Practicum Paper

Stepping into leadership positions as a new nursing administrator is challenging.

Preparing for such a role through academia bestows the rationale and theory for successful

decision making. Performing a learning practicum in a clinical setting allows the novice leader

opportunity to demonstrate teachings in a structured format. This paper provides the detail of

how the author will personally improve nursing administrator skills and abilities of four self-

selected American Nursing Association (ANA) Scope & Standards for Nursing Administrator

competencies, with guidance from a preceptor at MidMichigan Health (MMH)-Midland by

initiating a project for nurse manager orientation. It will also review best practice literature,

provide a structured learning plan and an evaluation method for achieving the stated goals

contained within the learning plan. The ANA Standards that are being exercised for the learning

practicum are #4, Planning: The nurse administrator develops a plan that prescribes strategies

and alternatives to attain expected outcomes, Standard #5, Implementation: The nurse

administrator implements the identified plan, Standard # 8, Education: The nurse administrator

attains knowledge and competency that reflects current practice, and Standard # 9, Professional

Practice Evaluation: The nurse administrator evaluates own nursing practice in relation to

professional practice standards and guidelines, relevant statutes, rules, and regulations (American

Nurses Association [ANA], 2009, p. 28, 29, 36, 37).

Learning Plan

In an effort to successfully improve administrator skills a learning plan was developed,

based upon the four ANA standards. The overall learning project centers on creating a nursing

specific orientation plan for nurse managers at MMH, while featuring the standards that the

author sensed were areas that needed to be strengthened for herself. The learning plan’s


competencies and learning outcomes were determined in reference to the ANA Scope &

Standards for Nursing Administrators and the American Organization of Nurse Executives

(AONE). The ANA standard, Professional practice evaluation was selected to help the author

understand professional practice in leadership procedure and decide the focus of the project for

the practicum learning plan. Planning and Implementation were chosen for the reason that

previous leadership experiences did not allow her to devote herself to formal processes to be

successful with project development and execution. Education was chosen, as the author needs

to understand the most recent best practices in order to lead others in their understanding and

foster buy in from the team for the project completion and success. Evidence based practice

(EBP) was utilized from sources within the last five years to support the activities to achieve the

learning outcomes. The learning practicum will take place September through December 2015.

It is the author’s expectation that the learning plan will structure the learning and development of

the skills needed to be a successful leader. To view the learning plan please see appendix A.

A Review of the Literature

An examination of the literature was performed to determine best practice activities to

develop the learning plan and support the practicum. According to the ANA, the nurse

administrator is defined as a nurse who coordinates and influences the efforts of others in a

designated department (2009). The question must be asked, how does the nurse prepare for such

a role in order to be successful? As there are varying degrees of preparation, including in some

instances very minimal, the novice nurse manager’s ability to effectively lead in today’s

healthcare system has long been in question. Since nurses are familiar within their clinical work

areas, oftentimes highly skilled bedside nurses have been promoted with the thought that a good

staff nurse equates a good nurse manager. However, newly appointed nurse managers have


demonstrated a lack of skill in regards to the competencies set forth by the ANA Scope and

Standards of Practice for Nursing Administration and the AONE. This literature review sets out

to determine the educational gaps for new nurse managers, as well as seeking innovative

opportunities for achieving the author’s improvement in nurse manager competencies of

planning, implementation, education and professional practice evaluation.

Electronic databases utilized for the traditional literature review included: CINAHL,

Cochrane, OVID, Pubmed, and Google Scholar. Keywords employed included: competency,

coaching, development, leadership, mentoring, nurse leader, nurse manager, orientation, and role

development. A total of 45 evidenced based articles were retrieved. Fifteen articles were

selected for review of the topic. There were limited articles within the last five years which

incorporated intra-hospital based orientation programs for middle leadership. Therefore, one

additional article was included from the last six years to be able to compare and contrast internal

and external programs.

Current Issues in the Literature

For the learning practicum it is important to compare and contrast research outcomes

related to nurse manager skill development. Within the last decade, there have been efforts set

forth to delineate the educational needs for the nurse manager in an effort to define a competent

leader. The ANA Scope and Standards of Practice for Nursing Administration were published in

2009, and provide detail for what competence means for the nurse leader. In addition to this, the

AONE provides competencies related to communication, knowledge, leadership, professionalism

and business skills ("AONE Nurse Executive Competencies," 2005). Despite having access to

these competencies, many organizations are unprepared for operationalizing them when

attempting to develop new leaders. At the same time, novice leaders are expected to be


proficient in them. The learning practicum will demonstrate competence in accordance with the

ANA Scope & Standards of Nursing of Planning by developing and implementing an orientation

process for new nurse managers that will better prepare them for the role.

The lack of structured nurse manager orientation models or programs is consistently

defined in the literature. Literature further confirms the promotion of unprepared bedside nurses

to leadership roles. Unlike staff nurses who fill general orientation classes in healthcare

organizations and often have structured processes, the nurse manager is usually hired

independent from others. Resources to hold formal in-house education classes are costly for the

few managers in number (Omoike et al., 2011). In addition to this, organizations that do have

general orientation programs for leaders they are not specialized for nurse manager’s unique

requirements (Fennimore & Wolf, 2011). The learning practicum supports the opportunity to

focus on the economic and financial management as set forth by the AONE when planning and

developing the new orientation plan for the few nurse managers in number.

The literature points to the need for improved educational models for novice nurse

managers in order to successfully lead in today’s healthcare environment. Over the last decade

there has been significant changes in healthcare which signify great challenges for the

unprepared novice nurse manager, including patient acuity, reimbursements and digital

technology (Fennimore & Wolf, 2011). According to the ANA Scope & Standards of Nursing

Administration, nurse leaders are expected to be competent in economic influence for the

decisions they make in their role (2009). If this is not achieved it could have significant impact

on the reimbursements for the departments, as well as the organization in which they lead.

Another financial consideration for achieving nurse leader competence is the return on

the investment of nurse manager specific programs for healthcare organizations and retaining


qualified manager. This can be justified with the reduction in staff turnover, which have direct

and indirect costs equaling approximately $85,000 in 2007 (Fennimore & Wolf, 2011). Other

possible returns on investment from successful completion of formal leadership courses are

improvements in patient quality and reimbursement outcomes (Fennimore & Wolf, 2011).

During the practicum the author will determine financial impact and turnover rates of nurse

managers at MMH in an effort to gain support for the cost benefit during program development.

Aside from the financial pressures, the role of the nurse manager is one of the most

difficult in healthcare. The role is seen as stressful and for one in constant flux (Digman et al.,

2012). It has been identified that unprepared nurse managers often lead by trial and error

(McCallin & Frankson, 2010). Therefore, it is vital for the novice nurse manager to develop the

necessary knowledge, skills and attitudes to lead successfully. There appears to be no consensus

on how to do this. However, there are benefits for healthcare to incorporate such programs. As,

effective leadership for nursing middle management has been shown to improve safe patient

outcomes and quality of care (Vitello-Cicciu, Weatherford, & Gemme, 2014). Despite this, there

is an obvious absence of adequate preparation for nursing managers, lacking structure to develop

and mentor the set forth competencies (Fennimore & Wolf, 2011). Structured programs are

needed to prevent this disparity. The learning practicum will focus on demonstrating the ANA

standard #8 of Education for facilitating educational offerings based on best practice of

preparation for nurse managers. According to the AONE, it is the responsibility of the nurse

leaders to collaborate and maintain academic relationships regarding the future of nursing and

healthcare (Nurse executive Competencies, 2005). The learning practicum will also provide this

opportunity by seeking the prospect to collaborate with local colleges and universities in

developing and providing the needed education.


Although academic institutions are now incorporating competency teachings into

curriculums, new nurse managers generally do not have this education prior to accepting a

leadership position. When the bedside nurse accepts the role of the nurse manager, the

expectation is that they immediately become project manager, an expert in human resource

management, budget expert, quality analyst, risk manager, compliance manager, mentor and role

model (McCallin & Frankson, 2010). According to Shirey et al., these unrealistic expectations

can lead to damaging results for healthcare (McCallin & Frankson, 2010). Fortunately, the

administrator expectation concepts are often included in curriculums in advanced nursing and

business degrees. However, advanced nursing degrees are not usually required for nurse

managers in many organizations (Omoike, Brooks, & Loyd Storfjell, 2011) which adds to the

disparity. It has been reported in 2003, 84% of nurses who hold executive positions in the

United States have Masters Degrees, whereas, 31% of nurse managers have attained them

(Digman et al., 2012). According to the Coalition of National Nursing Organizations, these

Master’s Degree programs encompass the fundamental competencies for leadership (Digman et

al., 2012). This further demonstrates the need to develop orientation programs for when they

step into the managerial role.

Literature Findings

The learning practicum includes conclusions from evidence based sources. It can be said

that leadership development programs hypothetically improve novice nurse manager skill with

competencies set forth by the AONE. In an effort to demonstrate this concept the Organization

of Nurse Leaders of Massachusetts and Rhode Island developed a nurse manager orientation

program which comprised of four classes over a two month period. Faculty were recruited from


the Organization of Nurse Leaders national chapter and employed group sessions, case studies,

project management, mentoring, reflecting and journaling (Vitello-Cicciu et al., 2014).

Qualitative data demonstrated nurses expressed behavior changes in the areas of self-awareness,

self-regulation to manage, being emotionally aware of others, seeking diverse feedback,

engaging in active listening, and having crucial conversations (Vitello-Cicciu et al., 2014). This

study expressed the belief that nurse managers experienced positive behavior changes after

attending a structured orientation program. The number of participants were few and the

responses were anecdotal in nature. Larger studies are needed to display repetition in results. In

addition to this, a more structured evaluation process elicited from nurse manager’s supervisors

would add value to the study results.

One distinction that is made in the most current literature is the need to collaborate with

outside entities to develop nurse manager orientation and competency development. This

appears to show strength in today’s economically challenged healthcare organizations. Having a

collaborative concept shares the expense for the greater good of all. The University of Pittsburgh

Medical Center (UPMC) Leadership Development for Nursing Middle Managers program

enlisted nurse executives, faculty from the university and graduate prepared human resource

experts to teach five full day sessions over two months (Fennimore & Wolf, 2011). It is

beneficial to have experienced presenters from university faculty, human resources whom are

graduate prepared, and internal nurse executives (Fennimore & Wolf, 2011). The curriculum

included activities such as reading evidence based literature, self-assessments, lecture, group

discussions, and assignments to apply and reflect learned material (Fennimore & Wolf, 2011).

Structured reflection can take many forms such as centering, journaling, and affirming (Chinn &

Kramer, 2008). Managers who completed the course self-reported an increase in understanding


15 pre-determined taught competencies, six months after the program completion (Fennimore &

Wolf, 2011). Managers also indicated the topics as being the most valuable to their success

included finance, conflict management, emotional intelligence application, and strategies to

engage staff (Fennimore & Wolf, 2011). The results of this study also indicated a verbalization

from the few participants of improved behaviors and knowledge after attending the program.

Again, the results are self-reported and subjective in nature. A more objective evaluation is

needed to confirm nurse manager commentary.

In 2010, in another small qualitative study of structured interviews with nurse managers,

three themes emerged. These themes include role ambiguity, business management deficits, and

role overload (McCallin & Frankson, 2010). The analysis of the themes lead to three

conclusions. First, leadership training should be offered to staff nurses who possess potential

role advancement attributes. Second, organizations must provide financial resources to provide

in house training for specific nurse management. And last, there should be ongoing mentorship

in a supervisory manner (McCallin & Frankson, 2010). These arguments point to the need for

organizations to improve in house nurse manager orientation programs and begin leadership

training to staff nurses who show future promise. There needs to be further studies to compare in

house versus collaborative ventures for orientation programs.

Other literature supports the findings for organizations to provide internal orientation

programs for new nurse managers. It is essential to focus on the leadership competencies which

correlate leader outcomes that are effective (Macphee, et al, 2014). In this study leadership

development focused on impacting relationships within the workplace to positively impact

outcomes (Macphee, et al, 2014). The education consisted of a four day workshop and included

lecture and interactive strategies for novice leaders (Macphee, et al, 2014). The study identified


knowledge gaps related to leadership outcomes and educational opportunities of empowering

behaviors to enhance them (Macphee, et al, 2014). The outcome of the study displayed that

empowering behaviors are teachable and are demonstrated one year after the four day workshop

(Macphee, et al, 2014). This study was limited by its small group of participants in the control

group. Duplicate studies with a substantial control group are needed to solidify results.

Earlier bodies of work appear to support an in house orientation program. In 2009,

Virginia Commonwealth University Health System in Richmond VA’s program concentrated on

elements of leadership, retention, clinical management, coaching, mentoring, human resources

management, fiscal management, performance improvement, and evidenced-based practice

through classroom teaching and competency checklists (Hawkins, Carter, & Nugent, 2009). In

this orientation program new nurse managers did not take responsibility of the department until

the orientation is complete in order to remain focused on the learning opportunities (Hawkins et

al., 2009). Anecdotally, the results reflected improvements in nurse manager satisfaction

reporting. There was no formal results from this program. However, there were lessons learned

to update the program, with no tangible results of its effect.

In reviewing the literature, there is consensus that any strategy to improve nurse manager

competencies must be innovative in nature. Again, collaborative efforts with academia is one

method to such innovation (Digman et al., 2012). Another innovative method is simulation.

Leadership development program participants can benefit from more engagement than didactic

sessions or computer based programs with simulations (Radovich et al., 2011). Since simulation

has been successful in other applications such as aviation, placing nurse leaders in lifelike

situations promotes behavioral aspects of understanding content (Radovich et al., 2011). One

pilot program aimed to develop and implement a leadership development program employing


three video recorded simulation scenarios, post simulation debriefing, and re-participation of the

three simulations (Radovich et al., 2011). Participants reported to have a better understanding of

how their communication, both verbal and non-verbal are perceived (Radovich et al., 2011).

Participants also felt they had an improved ability to have crucial conversations in difficult

situations (Radovich et al., 2011).

Other literature reviews the benefits of coaching versus mentoring. Even if the novice

nurse manager is fortunate to attend a leadership development program, there is still a need for

ongoing guidance and in the moment learning. Peer preceptors are often assigned to look after a

new manager. However, assigned preceptors for novice leaders are often consumed with the

demands of the role and offer minimal time to the new manager (DeCamli, Kirby, & Baldwin,

2010). The author will utilize a mentor in the form of a formal preceptor for the duration of the

practicum project for guidance and support.

Theories for Nurse Manager Development

When developing a learning plan it is important to include models with proven success.

Patricia Benner’s model from Novice to Expert presents an appropriate theoretical framework for

educating nurse managers when dealing with experiential learning. According to Benner, the

nurse has the capability to attain meanings with direct involvement in a given circumstance

(Chinn & Kramer, 2008). For the learning practicum, this concept will be utilized by the

immersion process. The author will be in the role of the experienced bedside nurse and

considered a novice when transitioning to the new role of nurse leader, attempting to become

proficient with the four standards identified in the learning plan. It is this process that will

enable the ability to gain the experience to apply learned concepts through Benner’s five levels

of skill acquisition include novice, advanced beginner, competent, proficient, and expert


(Abraham, 2011). Also attributed to Benner’s theory is that learning is secured through

repetition and over time (Abraham, 2011). The practicum will empower the author to experience

such repetition. Academic didactic teaching and best practice review alone is not optimal for

nursing administrator competency demonstration of skills and abilities. The literature points to

the importance of having opportunities for the novice nurse manager to practice strategies

reviewed in curriculums (Fennimore & Wolf, 2011). The learning practicum in a sense, provides

a leadership simulation opportunity in a real healthcare organization. According to Benner,

performing the task to demonstrate competence of defined criteria in the real world is essential

for measurement (Conley, Branowski, & Hanley, 2007). This type of practice within the

practicum can assist the learner with understanding the results of learned behavioral concepts.

According to Radovich et al, simulation of the complex issues related to the nurse manager role

can also provide an interactive method to acquire needed leadership skills including the various

aspects of effective communication (Radovich et al., 2011).

Transformational Leadership is an additional theoretical framework for the novice nurse

leader in this practicum. This framework for leadership is applicable to the learning practicum of

development of nursing leadership competencies, as it connects the drive of the follower to the

common intentions of the leader (Northouse, 2015). With transformational leadership there is a

sense of bonding with respect and trust between the leader and the team encouraging buy in

(Avolio & Yammarino, 2013). It is with this leadership style that will enable the author to assist

the team reach their fullest potential (Northouse, 2015) with the practicum project. When the

leader becomes engaged with the people, the parties involved become motivated (Northouse,

2015). This newly engaged team will ultimately help the longevity of the project after its

completion.


Literature Limitations

In an attempt to determine its validity for the learning practicum, the literature findings

were examined to review any limitations. For this process it is important to look for sources

which conduct systematic research with randomization of participants to provide Level V and VI

evidence which is considered to be reliable (Fineout-Overholt, Melnyk, Stillwell, & Williamson,

2010). The literature available provided qualitative and descriptive evidence. One weakness in

the literature is that each of the studies were performed in single organizations with minimal

participants. Another weakness, is that the majority of the most recent literature weighs heavily

on academic institutions to bridge the gap of current curriculums in collaborating with various

healthcare organizations to provide joint orientation programs. What is requested for curriculum

content at one organization may not be important to another. A project between several

organizations could be studied to gain numbers in experienced educators including nurse

executives, human resources and academic educators. It is interesting that none of the literature

mentioned actual nursing educators for leadership development. This could be in part due to the

downsizing of education departments within healthcare organizations.

Evaluation is essential to understand the effects of program outcomes at its completion.

Many of the literature sources relied heavily on self-reporting of perceptions from the individual

novice nurse managers. None of the articles confirmed an increase in physically demonstrating

an improvement in nursing leadership competencies by means of a direct supervisor.

Application would be of benefit in evaluating a true understanding and utilization of the

competencies trained.


Literature Review Conclusion

After reviewing the literature many things has been ascertained. Novice nurse managers

are often unprepared for leading in today’s healthcare system. Despite competency development

within the last decade from the ANA and the AONE, healthcare organizations lack structured

orientation programs specific to nurse managers. Earlier studies suggest providing in house

competency based orientation programs improves nurse manager knowledge and behaviors.

While more recent studies, point to collaborative efforts with outside entities such as Universities

to provide these types of programs. All literature points to innovation as being key to ensuring

novice nurse managers are prepared in today’s economic limitations. There are no evidence

based bodies of work which compares different types of orientation programs against one

another. Current studies have limited numbers of participants and provide subjective outcomes.

More research is needed to determine the most cost effective and comprehensive style of

program to provide to new nurse managers. Results from larger future studies should be

objective in nature. Healthcare stands to benefit when nurse managers are adequately prepared

for this challenging role.

Practicum Setting

The learning practicum will take place at (MMH)-Midland. This organization is a 240

bed, acute care, not for profit hospital that is headquarters of the (MMH) System in Lower

Michigan. MMH is also affiliated with the University of Michigan Health System, which

provides access to evidence based research outcomes, policy and procedure. Of note, the health

system has a strong nursing leader in the chief executive officer (CEO) position, Diane Postler

Slattery RN Ph.D. She is a strong proponent for advancing nursing practice with the financial

decision making incentive to do so. This is unique for a healthcare organization to have. The


nursing department is governed by a chief nursing officer, four nursing directors, ten nurse

managers and numerous supervisors. The nurse managers will be the focus of the project, but

will open up the project to nursing supervisors as well. This site was chosen because the author

had previous experience within the leadership team and a good understanding of the different

departments in which the practicum will evolve.

Preceptor Selection

For the selection of a preceptor for the learning practicum, a meeting was scheduled with

the Vice President and Chief Nursing Officer. Jan Penney, RN, MSN is a veteran nurse with a

long career in leadership and an excellent role model. She has vast experience as a leader as she

has been in the role of nurse manager, director and her current role. She has been in her current

role for 3 years and is the driving force of progressing the role of nursing at MMH for over 10

years. Mrs. Penney has been instrumental with improving quality and safety within the

organization during this time. She is currently advocating for MMH to adopt a nursing

philosophy and improving the organization’s culture of safety. It was decided that, despite her

elevated level within the organization, she be the preceptor for the proposed practicum.

Mrs. Penney will be the student’s direct liaison for each step of the practicum plan.

Because she is the VP of nursing, she will be instrumental with knowing the venues that will be

beneficial for the author to be a part of. She leads a monthly nursing managers and directors

meeting, which includes ancillary department leaders. These leaders will all be essential for the

student to be in contact with in various forms throughout the practicum.

This preceptor has demonstrated many attributes of a good preceptor. This includes

being a great communicator, very knowledgeable in the identified areas for the practicum, and is

motivated in seeing the success of the venture with the student (The Effective Preceptor). She


has accepted the responsibility of being an active observer over the practicum, and has a good

assessment of the student’s skills and abilities as a nursing leader. To view the preceptor/agency

agreement please see appendix B.

Evaluation Process

The evaluation process for lifelong learning is essential to determine if one has achieved

the goals and learning objectives set forth. This is true for the learning practicum as well. It is

important to ensure that the evaluator is able to objectively evaluate one individual against

another in a fair and consistent manner. When the evaluation process is based on measurable

learning outcomes, the learner is able to determine the steps necessary to achieve them.

Bloom’s Taxonomy is one such method in determining educational objectives. It is

important for the learner to move through the six categories of cognitive skills which include;

knowledge, comprehension, application, analysis, synthesis, and evaluation ("A model of

learning objectives," 2015). This approach can be closely linked to Patricia Benner’s model of

learning from novice to expert (Abraham, 2011), as one must acquire the knowledge as a novice

then move through the stages of application, analysis, and synthesis before becoming an expert.

Closely related to Blooms Taxonomy and Benner’s Learning Theory, is the Office of

Human Resources at the National Institutes of Health’s evaluation descriptors. These five

descriptors include fundamental awareness, novice, intermediate, advanced and expert (2009).

These descriptors were utilized in the development of the evaluation tool for the learning

practicum. To view the learning practicum evaluation please see appendix C.

Conclusion

Transitioning into a nurse administrator position can be a challenge. Simulating real life

learning opportunities via a structured learning practicum can help novice managers overcome


these challenges. With the guidance of a preceptor, the author will utilize evidence based

practice strategies to initiate a nurse manager orientation project to assist with improving skills

and abilities. The learning practicum will take place at MMH from September through

December of 2015, and focus on activities to achieve outcomes for four ANA Scope & Standards

of Nursing Administration including; planning, implementing, educating and professional

practice evaluation. This will be evaluated using Bloom’s taxonomy at the mid-point of the

practicum, as well as at the conclusion.


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Appendix A

Clinical Practicum II Learning Plan Template- M Wendt

ANA Standards of Practice: Specialty roleADMINISTRATION

Outcome Criteria: (taken from the ANA Standards/NLNCompetencies)

Activities to Achieve Outcome.

Resources needed to be successful

Timeline

Standard #4Planning

The nurse administrator develops a plan that prescribes strategies and alternatives to attain expected outcomes.

(American Nurses Association [ANA], 2009, p. 28)

1. Participates in the design and development of multidisciplinary and interdisciplinary processes to address the situation or issue.


1.A. Develop

evidence based orientation plan/policy/ process for nurse manager group using an interdisciplinary approach at MidMichigan Health (MMH).

B. Analyze current policy on nurse manager orientation related to

1A.a) Literature on

best practice for nurse manager orientation processes.

b) AONE Nurse executive competencies.

c) ANA Administration Scope and Standards

d) Nursing and non-nursing theory for learning & change. (Most likely Benner/ Novice to Expert, Studor, Lewin?)

e) Nursing philosophy (Newly developed Summer 2015)

1B.a) Current

orientation policy and tool/checklist

Sept-Dec 2015


2. Considers the economic impact of the plan.

(American Nurses

non-nursing departments

C. Revise key educational topics/checklist needed for nurse manager success.

D. Perform Root Cause analysis or FEMA for current/recent orientation deficiencies.

E. Determine common stressors of newly hired nurse managers.

2.A. Develop cost

analysis of proposed plan. (Included: the cost of nurse manager

1C. a. List of ancillary

non-nursing department’s liason.

b. Current orientation tool/checklist.

1D.a. Meeting with

current nurse managers, directors, education department manager, HR representation, and VP of nursing for topics to be included in new process/ identify weaknesses in current process.

1E.a. Meeting with

current nurse managers to discuss experiences

b. Literature on stressors of the new nurse manager

2A.a. Meeting with

human resource.


Association [ANA], 2009, p. 28)

turnover).

B. Determine time allotment for orientation.

C. Determine budget availability for outside programs.

D. Calculate cost benefit ratio of orientation/ nurse manager turnover.

b. EBP literature for cost of nurse manager turnover and time devoted to orientation process.

2Ba. Meeting with

Nursing Directors & VP of nursing

2C.a. Meeting with

Nursing Directors & VP of nursing

2D.a. Meeting with

finance department to determine cost/benefit ratios.

Standard #5Implementation

The nurse administrator implements the identified plan.


1. Facilitates utilization of systems and community resources to implement the plan


1.A. Organize

meetings with in house departments (Physician stakeholder included), as well as possible community entities to determine available resources.

1A.a. Contact person

for various departments and organizations.

Sept-Dec 2015


2. Collaboration with nursing colleagues and others to implement the plan.


2.A. Determine

responsibilities for process completion at the end of 6 months after hire.

2A.a. Meeting with

stakeholders (Including human resources)

b. Contact person for various stakeholders.

c. Calendars for various stakeholders

Standard # 8Education

The nurse administrator attains knowledge and competency that reflects current practice.


1. Seeks experiences and independent learning activities that reflect current practice in order to develop, maintain and improve skills and competencies in nursing administration role.


2. Maintains professional records that provide evidence of competency and lifelong learning.

1.A. List learning

opportunities for nurse manager education.

B. Determine current offerings for nurse manager orientation at MidMichigan Health

2.A. Construct

competency tool utilized for nurse manager orientation to maintain in human resources file.

1A.a. Collaborate with

local universities and colleges.

b. List of yearly state conference offerings for nurse manager conferences

1B.a. Meeting with

education department

2A.a. Tools utilized to

document competency from other organizations.

Sept-Dec 2015



B. Utilize hospital technology to obtain data regarding nurse manager competencies

2B. a. IT liaison b. Human resource

data

Standard # 9

Professional Practice

Evaluation

The nurse administrator evaluates own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations.


1. Interacts with peers and colleagues to enhance own professional nursing practice and role performance.


2. Takes actions to achieve goals identified during the evaluation process.


1.A. Determine what

is needed to enhance nurse manager professional practice as leaders.

B. Create and communicate project outcomes in a non-threatening manner

2.A. Develop

evaluation process for the completion of the nurse leader orientation process.

B. Measure and analyze performance from learning

1A.a. AONE Nurse

executive competencies.

b. Meeting with Nurse managers/Directors

2B. Transformational Leadership guidelines and literature

2A.a. Local healthcare

organization’s evaluation processes.

b. Evidence based practice evaluation methods.

2B. Benchmarking of nursing data for turnover rates & magnet designation status

Sept-Dec 2015


Appendix B

Student-Preceptor-Agency- Agreement

The overall objective of this experience is to provide an on-site setting in which a student, with the preceptor (professional employee of a health care agency), can further develop his/her understanding and skills related to an advanced nursing role specialty.

Agency name ____MidMichigan Health-MidlandStudent name ___Marie Wendt_______Student Telephone # ___989-529-1957

Preceptor name __Jan Penney RN, MSN__ Preceptor’s Title:__ Vice President and Chief Nursing OfficerPreceptor Telephone #____ 989-839-3645 Email_ [email protected]

Agency representative ___Colleen Markel___Agency representative Title _ Manager of Workforce DevelopmentAgency representative Telephone #__989-839-3120 [email protected]

The following learning outcomes and activities will be completed by the student during this project/practicum.

A. Develop evidence based orientation plan/policy/ process for nurse manager group using an interdisciplinary approach at MidMichigan Health (MMH).

B. Analyze current policy on nurse manager orientation related to non-nursing departments C. Revise key educational topics/checklist needed for nurse manager successD. Perform Root Cause analysis or FEMA for current/recent orientation deficiencies.E. Develop cost analysis of proposed plan. (Included: the cost of nurse manager turnover). F. Determine budget availability for outside programs.G. Organize meetings with in house departments (Physician stakeholder included), as well as

possible community entities to determine available resources.H. Construct competency tool utilized for nurse manager orientation to maintain in human

resources file. I. Utilize hospital technology to obtain data regarding nurse manager competenciesJ. Develop evaluation process for the completion of the nurse leader orientation process.

SIGNATURE SIGNIFYING AGREEMENT TO THE TERMS OF THIS PRECEPTOR AGREEMENT:

Student _________________________________________ Date ___________________

Preceptor(s) _______________________________________ Date ___________________

Agency representative _______________________________ Date ___________________


Appendix C Learning Practicum Evaluation ToolMarie Wendt RN, BSNFerris State University

***CHOOSE ONE***→ Midterm Evaluation _______ October 12, 20115 OR Final Evaluation ______ November 30, 2015

Evaluation Key:

Score Proficiency Level Description

N/A Not Applicable You are not required to apply or demonstrate this competency. This competency is not applicable to your position.

1Fundamental

Awareness(basic knowledge)

You have a common knowledge or an understanding of basic techniques and concepts.

Focus is on learning.

2 Novice(limited experience)

You have the level of experience gained in a classroom and/or experimental scenarios or as a trainee on-the-job. You are expected to need help when performing this skill.

Focus is on developing through on-the-job experience; You understand and can discuss terminology, concepts, principles, and issues related to this

competency; You utilize the full range of reference and resource materials in this competency.

3 Intermediate(practical

application)

You are able to successfully complete tasks in this competency as requested. Help from an expert may be required from time to time, but you can usually perform the skill independently.

Focus is on applying and enhancing knowledge or skill;

You have applied this competency to situations occasionally while needing minimal guidance to perform successfully;

You understand and can discuss the application and implications of changes to processes,


policies, and procedures in this area.

4 Advanced(applied theory)

You can perform the actions associated with this skill without assistance. You are certainly recognized within your immediate organization as "a person to ask" when difficult questions arise regarding this skill.

Focus is on broad organizational/professional issues; You have consistently provided practical/relevant ideas and perspectives on process or practice

improvements which may easily be implemented; You are capable of coaching others in the application of this competency by translating

complex nuances relating to this competency into easy to understand terms; You participate in senior level discussions regarding this competency; You assist in the development of reference and resource materials in this competency.

5Expert

(recognized authority)

You are known as an expert in this area. You can provide guidance, troubleshoot and answer questions related to this area of expertise and the field where the skill is used.

Focus is strategic; You have demonstrated consistent excellence in applying this competency across multiple

projects and/or organizations; You are considered the “go to” person in this area within NIH and/or outside organizations; You create new applications for and/or lead the development of reference and resource

materials for this competency; You are able to diagram or explain the relevant process elements and issues in relation to

organizational issues and trends in sufficient detail during discussions and presentations, to foster a greater understanding among internal and external colleagues and constituents.

(Office of Human Resources at the National Institutes of Health, 2009, table 1)


***Please place a check mark in the appropriate box.

Standard #4Planning

The nurse administrator develops a plan that prescribes strategies and alternatives to attain expected outcomes.


Participates in the design and development of multidisciplinary and interdisciplinary process to address the situation or issue(American Nurses Association [ANA], 2009, p. 28)

Not Applicable

Fundamental

Awareness

Novice Intermediate Advanced Expert

Utilizes evidence based literature in development of orientation project processActively demonstrates utilization of theory during project processIncorporates newly developed MMH nursing philosophy in planning of process of the nurse manager orientation process.Develops newly structured nurse manager orientation policy.Collaborates well with current nurse manager team well to develop new policy, protocol, and checklist.Collaborates well with current ancillary departments personnel including human resources and educational services.Conducts an effective RCA/FMEA with appropriate stakeholders and utilizes


findings to determine gaps in current process.

Considers the economic impact of the plan (American Nurses Association [ANA], 2009, p. 28)Not

ApplicableFundamenta

lAwareness


Effectively collaborates with finance department in developing cost effective plan.Effectively collaborates with senior leadership (Nursing Directors and VP, Education, Human Resources) in understanding financial impact of orientation plan.Applies best practice evidence of financial limitations related to effective nurse manager orientation

Standard #5Implementation

The nurse administrator implements the identified plan. (American Nurses Association [ANA], 2009, p. 29)

Facilitates utilization of systems and community resources to implement the plan (American Nurses Association [ANA], 2009, p. 29)Not


lAwareness

Novice Intermediate

Advanced Expert

Facilitates meetings with ancillary departments, physician stakeholders and community entities to determine available


resources.Arranges consultation with state academic and healthcare institutions to compare leadership education strategies

Collaboration with nursing colleagues and others to implement the plan. (American Nurses Association [ANA], 2009, p. 29)Not


lAwareness

Novice Intermediate

Advanced Expert

Collaborates with leaders to determine appropriate and available resources to teach various aspects of the plan.

Collaborates with individual ancillary departments to design the implementation strategy.

Standard # 8Education

The nurse administrator attains knowledge and competency that reflects current practice.(American Nurses Association [ANA], 2009, p. 36)

Seeks experiences and learning activities that reflect current practice in order to develop, maintain, and improve skills and competencies in nursing administration role. (American Nurses Association [ANA], 2009, p. 36)

Not Applicable

Fundamental

Awareness

Novice Intermediate

Advanced Expert


Able to list current offerings for nurse manager orientation.Able to list learning opportunities for furthering nurse manager orientation competency understanding.Collaborates with local academic institutions to address gaps in leadership preparation

Maintains professional records that provide evidence of competency and lifelong learning. (American Nurses Association [ANA], 2009, p. 36)

Not Applicable

Fundamental

Awareness


Constructs competency tool to be utilized for nurse manager orientation to be maintained in human resources file.

Develops new nurse manager evidenced based reference binder.

Standard # 9Professional Practice

Evaluation

The nurse administrator evaluates own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations.


Interacts with peers and colleagues to enhance own professional nursing practice and role performance. (American Nurses Association [ANA], 2009, p. 37)


Not Applicable

Fundamental

Awareness

Novice Intermediate

Advanced Expert

Analyzes gaps in current nurse manager professional practice at MMHAssembles social support system into the nurse manager orientation process

Takes actions to achieve goals identified during the evaluation process. (American Nurses Association [ANA], 2009, p. 37)Not

ApplicableFundamentalAwareness

Novice Intermediate

Advanced Expert

Constructs process for evaluating new orientation process/policy using EBPDevelops process for team evaluation of orientation project outcome

EVALUATOR’S general comments:

STUDENTS Comments:


Student Name________________________ Student Signature________________________________ Date: ________________

Evaluator’s Name_______________________ Evaluators Signature _____________________________ Date: ________________

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