Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice

Environment

Susan M. Dyess, PhD, RN, AHN-BC, NE-BC

Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Beth A. Pratt, MSN, RN
Lenny Chiang-Hanisko, PhD, RN

Abstract

Citation: Dyess, S., Sherman, R., Pratt, B., Chiang-Hanisko, L., (January 14, 2016) "Growing
Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice
Environment" OJIN: The Online Journal of Issues in Nursing Vol. 21 No. 1.

Keywords: Nursing leadership, emerging nurse leaders, practice environments, succession

planning, healthy work environments, multi-generational workforce, Generation Y, academic-
practice partnership, leadership development

The development of future leaders is a vital obligation for current nurse leaders. Yet despite
recognition of the need to do succession planning, the absence of an adequate leadership pipeline
has been cited as a key challenge in nursing today (Thompson, 2008; Sherman & Pross,
2010; Sverdlik, 2012). We now find ourselves at the convergence of a perfect storm in
healthcare. Three million baby boomers born 1946-1964 (Zemke, Raines, & Filipczak, 2000)
will turn 65 each year for the next twenty years (American Hospital Association [AHA], 2014).
Their growing needs for services will place huge demands on an already challenged health
delivery system. At the same time, many current nurse leaders are in this same generational
cohort and will soon retire (Hader, Saver & Stelzer, 2006). Their potential replacements will be
an equally large cohort of Generation Y nurses born between 1980 and 2000 who are expected to
comprise 50% of the nursing workforce by 2020 (AHA, 2014). With the changes accompanying
health reform, these young nurse leaders have a unique opportunity to play key roles in
partnering with other healthcare professionals to lead in the improvement and design of the
health system and practice environments (Institute of Medicine [IOM], 2010). To meet these
challenges, we need to be certain that we have a large enough cadre of emerging leaders in
nursing who are both interested in leadership and well prepared to assume the roles (American
Organization of Nurse Executives [AONE], 2014; Scott & Yoder-Wise, 2013).

In January 2012, an academic-practice partnership composed of 24 community leaders was

formed in South Florida. The project goal was to recruit young nurses early in their careers into a
Master’s degree program in Nursing Administration and Financial Leadership before they accept
formal leadership roles. This is a paradigm shift from the historical pattern where nurse leaders
have often “fallen into their positions” without leadership education (Sherman, Bishop,
Eggenberger & Karden, 2007). With the growing complexity in leadership roles, community
nurse leaders recognized the value of having emerging nurse leaders who would assume these
roles with leadership education and the right skill set. Dr. Tim Porter-O’Grady, an internationally
known nurse futurist, served as a consultant on the project.

This article reports on focus group research conducted as part of a larger study with each of three
program cohorts prior to beginning their academic education. The findings indicate that future
nurse leaders may be reluctant, even fearful, of entering formal leadership roles. Yet, they are
also hopeful that their efforts can contribute to improving work environments, unite teams, and
implement changes needed to advance healthcare. Their perspectives about leadership before
they assume the role provide valuable insight into current nurse-nurse leader relationships and
also have implications for the planning of future leadership development programs and
succession planning efforts.

Emerging Nurse Leader Development

Effective succession planning through the identification and development of emerging nurse
leaders is now recognized as an essential business strategy for organizations (Kim, 2012).
Nursing workforce predictions indicate that there could be a shortage of up to 67,000 nurse
managers by 2020 (Shirey, 2006). Not only is there a strong business case for orderly transitions
in organizations, but younger staff now look for these professional opportunities when seeking
employment. Meister and Willyerd (2010) in their research with thousands of members of
Generation Y found that an employer’s willingness to develop the skills and talents of their staff
ranked first in 10 criteria used by this generation to select a new position.
Shirey (2009) describes the first ten years of nursing practice as the “promise phase.” She
observes that it is during this phase that young nurses are both socialized into the profession but
also gain the knowledge and skills to help position them for the future. Generation Y (born
between 1980 and 2000) are in this phase of their careers and are ideal candidates for emerging
leader programs. Successful experiences in developmental programs can translate into a nursing
leadership career (Bulmer, 2013; Titzer, Shirey & Hauck, 2014). While most of their beliefs and
values are not vastly dissimilar from other cohorts at a similar point in their development,
Generation Y has two compelling differences in behavior from the generations who preceded
them that need to be taken into consideration when doing leadership development. The first is
their incorporation of technology as a “sixth sense” and a means of interacting with the world.
The second is their expectation of organizational accommodation that is an outgrowth of how
they were parented and treated throughout their education (McCready, 2011).

It is this expectation of accommodation that has proven to be challenging for many nurse leaders.
Leadership strategies and developmental activities that have worked well with other generations
are not always as effective with our newest generation of nurses – Generation Y (Hutchinson,
Brown & Longworth, 2012). Turnover in the first year of employment among this generation is a
persistent problem in many organizations. Generation Y nurses are less accepting and more
critical about workplace practices than the generations who have preceded them. The RN Work
Project funded by the Robert Wood Johnson foundation is a longitudinal study that tracks a
national sample of new nurses focusing on their career changes and work attitudes. Currently,
31% of new graduates leave their first job within the first two years and almost three quarters
(73%) do not receive guidance to appraise gaps in practice or how to respond as a member of the
professional team with practice environment improvement initiatives (RN Work Project, 2014).

In spite of this higher job turnover, Generation Y is optimistic about nursing and may leave
employers but not the profession. In a recent nationwide study conducted by AMN Healthcare
(2013), this age group was the most likely to recommend nursing as a career. They also report
more interest in pursuing higher education in nursing. When satisfied with their jobs, they have
been noted to have greater organizational commitment than either Generation X or the Baby
Boomers (Keepnews, Brewer, Kovner & Shinn, 2010) but are also more likely to monitor and
consider employment opportunities in other settings (Tourangeau, Thomson, Cummings &
Cranley, 2013). Recruiting and retaining Generation Y nurses in leadership may prove
challenging without significant changes in the current structure of roles. Fear of failure is a
significant concern in this generation (American Psychological Association [APA], 2012), so
leadership development programs that promote hope and encouragement about the progress that
they are making is important feedback. Generation Y nurses are just beginning to move into
leadership roles. There are few studies about their perceptions of current leaders and their
potential contributions in these roles. In order to accomplish more effective succession planning,
a better understanding is needed about motivational and environmental factors that could prove
challenging in their willingness to become leaders and accept leadership responsibilities.

REFLECTION:

There are so many number of nurses who wants to retire and new nurses and new opportunity for
them are coming, With the growing complexity of healthcare practice environments and pending
nurse leader retirements, the development of future nurse leaders is increasingly important. This
article reports on focus group research conducted with Generation Y nurses prior to their
initiating coursework in a Master’s Degree program designed to support development of future
nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this
qualitative study conducted to capture perspectives about nursing leaders and leadership.
Conventional content analysis was used to analyze and code the data into categories.
they discuss the three major categories identified, including: idealistic expectations of leaders,
leading in a challenging practice environment, and cautious but optimistic outlook about their
own leadership and future, and study limitations. The conclusion offers implications for future
nurse leader development. The findings provide important insight into the viewpoints of nurses
today about leaders and leadership.