Effective staff development programme for nurses - Research Paper Example

Effective staff development programme for nurses Introduction The present health care environment requires nurses and health care practitioners to constantly update their knowledge and skills to improve health care services provided to patients. The Australian Nursing and Midwifery Council (ANMC) (2005) asserted the role of learning in a nurse’s professional life: “the registered nurse contributes to quality health care through lifelong learning and professional development of herself/himself and others” (p.2). This means that nurses are responsible for their own skills and knowledge development, as well as in promoting the same learning environment for other health care workers. Furthermore, the demands for greater accountability have increased, amidst limited organisational resources. Training initiatives must both support lifelong education and prepare health care workers in undertaking their diverse roles and responsibilities in a timely, efficient, and effective manner. This paper explores the changes needed for my organisation in developing an effective staff development programme. Analysis of Organisation Change Needed I am serving as the nurse educator in _____. Numerous new nurses, such as fresh graduates and overseas nurses, work at WA hospitals. One of the common causes of problems and errors in their role that deprives the patient from quality nursing care is lack of support from the senior staff and management, especially staff development educators and managers. Through observations and interviews with nurses, I learned that self-directed learning, which is often used in the hospital, is not very effective in supporting the learning needs of health care workers. Many nurses only read training manuals designed for them for compliance, without fully absorbing and implementing the knowledge and skills that these manuals intend to teach them. This paper aims to design an effective education approach for the nurses in the ward that could be effective in the workplace. Type of Skills for Nurse Educators A Clinical Nurse Educator is a registered professional nurse with an advanced education, including postgraduate clinical and educational training combined with several years of expertise in a healthcare specialty (Coe, n.d.). A combination of clinical expertise and a passion for teaching are two of the fundamental skills that are needed by nurse educators (March & Ambrose, 2010). Nurse educators should have research and writing skills needed to identify learning needs and develop the right educational programmes and teaching strategies for their target learners (March & Ambrose, 2010). They should also have classroom teaching skills, where they are prepared to design and assess academic and continuing education programs for nurses and clinical staff (Coe, n.d.). At the workplace, they design informal continuing education programs that aim to enhance professional competencies as part of the individual learning needs. In addition, nurse educators serve as leaders who redefine processes for improved work-flow, document the results of educational programs and assist staff, students and patients through the learning process (Coe, n.d.). Nurse teams work closely with healthcare professionals and patients to develop enhanced disease outcomes and innovative approaches for patient management, which ranges training of professionals on new treatment protocols to working with patients and health care workers to instruct, train, advice and provide clinical support (Coe, n.d.). Management of Resistance to Change Marquis and Huston (2000) contended that because change can upset the “homeostasis, or balance, within a group resistance should always be expected.” The intensity of resistance will depend on the type of change. Since this paper involves changing attitudes and practices in learning, it is possible that there will be moderate to high resistance, not because health care workers do not intend to improve their competencies, but because of the changes needed in the learning and work environment. Harvey (1995) asserted that “change without resistance is no change at all-- it is an illusion of change.” Nurse educators should be able to recognise resistance and plan and execute strategies to reduce or prevent it (Curtis & White, 2002, p.15). Resistance to change pertains to any employee behaviours that question, delay or avert the implementation of a work change (Curtis & White, 2002, p.15). Employees may oppose change for several reasons, and understanding them can assist change agents in executing changes more effectively (Curtis & White, 2002, p.15). Strategies for reducing resistance are discussed. First, introduce changes slowly. Radical changes often meet the greatest level of resistance. Also, in changing something slowly, people who will be affected and are involved in the change can have enough time to think about the importance of these changes to their jobs and organisations (Curtis & White, 2002, p.18). Second, nurse educators should elicit the participation of concerned stakeholders. Participation can be the most effective strategy for lessening or overcoming resistance to change (Curtis & White, 2002, p.18). Third, nurse educators should develop psychological ownership for the change programme (Curtis & White, 2002, p.18). Psychological ownership is a crucial theory to reducing psychological resistance to change (Curtis & White, 2002, p.18). It pertains to a feeling of being psychologically connected to an object/organisation and having a sense of possessiveness for that object/ organisation (Dirks et al., 1996 cited in Curtis & White, 2002, p.18). This theory asserts that there are three fundamental self-needs: “self-enhancement, self-continuity and control and efficacy” (Curtis & White, 2002, p.18). Individuals may be less likely to oppose change when it is “self-initiated, evolutionary and/or additive” as these kinds of change do not undermine fundamental self-needs (Curtis & White, 2002, p.18). Fourth, educating people about the need for the change and its possible benefits is very significant and may help to diminish resistance. Fifth, trust should also be developed. This can be attained through and honest communication throughout the change process. Finally, providing additional support is also critical, such as extra education, extra staff during the training period and decrease of workload during the change process (Curtis & White, 2002, p.18). Recommendation Effective Staff Development Programme Mentorship and coaching are some of the practices that could support an effective staff development programme. It is evident that the hospital needs a competency-based approach that is appropriate to hospital policies and guidelines, as well as the ANMC (Australian Nursing and Midwifery Council) guidelines. In “Building the Capacity for Evidence-based Clinical Nursing Leadership,” Alleyne and Jumaa (2007) aimed to help primary care nurses connect management and leadership theories and clinical practice, through group clinical supervision (GCS) sessions, so that participants can develop their decision-making skills. Findings showed that through executive co-coaching, participants were more accomplished in learning systematically from the past, using evidence-based clinical nursing leadership (EBCNL). Mentorship is also a growing educational approach in health care workplaces. Block et al. (2005) defined nurse mentorship as a relationship between two nurses, where trust and compatibility are significant, so that they can reach personal and professional objectives (p.34). They concluded that mentorship has sensible benefits for nurses and nursing organizations. Change, however, is not easy to implement. A change management programme is also needed to implement the staff development programme. The change development programme will make use of Lewin’s change model. The most common is Lewin’s three stage change model, which consisted of the stages of unfreezing, changing, and refreezing (Matthews, 2009, p.7). Unfreezing pertains to creating the need for changes; changing refers to pursing changes in attitude and conduct; and refreezing pertains to institutionalizing changes made (Matthews, 2009, p.7). Unfreezing pertains to the shake up phase that is triggered, in this case, by the need of decreasing errors in the health care setting and enhancing the professional competencies of the health care staff. The outcome is an acknowledgment that the existing structures and ways are not working to get people ready for changes (Module Two, n.d., p.2). Concerned health care practitioners will be informed of the following aspects of change: Necessity of change. Change is needed in how health care workers are trained. It should shift from self-directed learning to mentorship and coaching practices. The primary changes include using more mentoring and coaching techniques in identifying and training required competencies for different health care workers. In the article “Mentorship in Nursing: A Literature Review” by Andrews and Wallis (1999), they studied mentoring literature in nursing practice. They recommended the use of “mentoring teams” instead of “supervisory” panels for postgraduate nursing students, and for mentors to receive official training in mentorship to improve their capabilities in responding to their students' learning needs. Myall, Levett-Jones, and Lathlean (2008) and Ryan, Goldberg, and Evans (2010) agreed with these findings. Nature of change needed. The nature of change is educational in nature, but it requires changing attitudes and practices towards learning. Learning does not have to be mostly self-directed but use mentorship and coaching. Methods planned to achieve the change. The methods used to achieve change are to prepare health care workers who are in the position to be coaches and mentors to be actual coaches and mentors for nurses. Change management is also needed, which is already outlined in this section of the paper. Needs of those affected. The needs of the coaches and mentors are for them to have particular teaching, interpersonal, and communication skills for their new roles and responsibilities. Myall, Levett-Jones, and Lathlean (2008) examined the purpose of mentorship in nursing practice using British and Australian case studies. Findings showed that mentorship is important to pre-service nurses and that mentors need formal training as educators. Students also felt the connection between the quality of mentoring and their connection with their clinical areas, which helped them have a deeper form of learning. Ways that progress will be planned and monitored. Progress will be monitored through observation and surveys on the satisfaction and learning/teaching needs of students/coaches/mentors. Changing pertains to the process of designing and implementing the change. Define the problem. The problem is that self-directed learning is time-efficient, but not effective in teaching health care practitioners the competencies they need to perform their wide roles and responsibilities. They need coaches and mentors to help them develop and improve their professional competencies. Identify solutions. The solution is through mentorship and coaching, where appropriate. Haidar (2007) used case study research to show why mentors should recognise the theories and approaches to mentorship. Findings demonstrated that mentorship benefits mentors, students, and general care; mentoring teams are better than single mentors, because no mentor can successfully serve all the purposes of mentoring; teaching styles must reproduce the learning styles of students; mentors can use usual models to determine and reach goals, such as the Specific, Measurable, Attainable, Realistic, and Time-bound (SMART) model; mentors should be conscious of the mentee stages of their students; proper communication is important to mentorship; and mentors should embark on reflection and analysis of feedback. Coaching promote professional growth and facilitate knowledge, attitude, and skills changes (Locke, 2008, pp.103-104). Devise appropriate strategy to apply change. The proper strategy is to use communication and participation to reduce resistance to change. Locke (2008) underscored the significance of developing leaders as coaches, which is critical to this programme. First, the nurse educator will collect ideas, feelings, and opinions from possible mentors/coaches and learners, about the competencies they need to work on. Second, she will develop the programme that will help mentors/coaches in enhancing the competencies of target learners. The nurse educator can also act as coach/mentor for her own specialty. Implement solutions. Solutions will be implemented in an incremental manner, so that resistance to change can be reduced. Refreezing pertains to the process of maintaining the momentum of change. Locking in the changes. Changes will be locked in through evaluation and sharing learning outcomes and other success factors. Stabilising the situation. Stabilisation can be attained through institutionalising the programme through organisational policies and procedures. Building relationships. Relationships with mentors/coaches and learners must be constantly developed and nurtured. Their feedback and suggestions should help improve upcoming staff development programmes. Conclusion The change needed in the organisation is to adapt mentoring and coaching in producing an effective staff development programme. The change management strategy consists of open communication and participation of learners and mentors. This paper discusses the unfreezing, changing, and refreezing actions for the programme. This programme aims to offer practical solutions to diverse learning needs of health care workers and to implement feasible teaching strategies. References Alleyne, J. & Jumaa, M.O. (2007). Building the capacity for evidence-based clinical nursing leadership: The role of executive co-coaching and group clinical supervision for quality patient services. Journal of Nursing Management, 15 (2), 230-243. Andrews, M. & Wallis, M. (1999). Mentorship in nursing: A literature review. Journal of Advanced Nursing, 29 (1), 201-207. Australian Nursing and Midwifery Council (ANMC). (2005). National Competency Standards for the Registered Nurse. Retrieved from http://theses.flinders.edu.au/uploads/approved/adt-SFU20100708.110421/public/09Appendix7.pdf Block, L.M., Claffey, C., Korow, M.K.., & McCaffrey, R. (2005). The value of mentorship within nursing organizations. Nursing Forum, 40 (4), 34-140. Coe, S. (no date). The expanding role of the nurse educator. Retrieved from http://www.nursetogether.com/tabid/102/itemid/1478/The-Expanding-Role-of-the-Nurse-Educator.aspx Curtis, E. & White, P. (2002). Resistance to change. Nursing Management-UK, 8 (10), 15-20. Haidar, E. (2007). Coaching and mentoring nursing students. Nursing Management, 14 (8), 32-35. Harvey T.R. (1995). Checklist for change: A pragmatic approach to creating and controlling change (2nd ed.). Lancaster PA: Technomic Publishing Inc. Locke, A. (2008). Developmental coaching: Bridge to organizational success. Creative Nursing, 14 (3), 102-110. March, K.S. & Ambrose, J.M. (2010). Rx for NCLEX-RN success: Reflections on development of an effective preparation process for senior baccalaureate students. Nursing Education Perspectives, 31 (4), 230-232. Marquis, B.L. & Huston, C.J. (2000). Leadership roles and management functions in nursing: Theory and application (3rd ed.). Philadelphia PA, Lippincott. Mathews, J. (2009). Models of change management: a reanalysis. ICFAI Journal of Business Strategy, 6 (2), 7-17. Module Two Change Management Theories & Models. Myall, M., Levett-Jones, T., & Lathlean, J. (2008). Mentorship in contemporary practice: The experiences of nursing students and practice mentors. Journal of Clinical Nursing, 17 (14), 1834-1842. Ryan, A., Goldberg, L., & Evans, J. (2010). Wise women: Mentoring as relational learning in perinatal nursing practice. Journal of Clinical Nursing, 19 (1/2), 183-191. Read More