The essence of a leader is to serve as a visionary while providing guidance, support and the tools employees need to thrive. That’s why the nursing leadership structure at UW Health is designed to provide RNs with local support while promoting a culture of accessibility to all nursing leaders and transparency in communication.
Working with RNs to address important issues
Through the UW Health Nursing Shared Governance Council structure, nursing leaders attend system-level council meetings to provide executive support to each council and help move work forward, whenever needed. Two prime examples from 2022 pertain to the ever-hot topic of staffing:
- Short- and long-term staffing solutions
At the peak of the RN staffing crisis, executive nursing leaders quickly launched an Internal Traveler Program to leverage talent from within the organization to fill shifts, with additional pay incentives. Although the program was successful in filling 90% of open shifts, it was a short-term solution due to the financial strain on the organization. To work toward a more sustainable solution, leaders engaged the Nurse Staffing and Operations Council and other direct care RNs to gain insight on what might work best.
“The RN input we received was extremely insightful and helped us arrive at a long-term solution,” said Rudy Jackson, chief nurse executive.
The result was a phased staffing plan involving four phases based on need (normal, urgent, critical or crisis), with relative incentive pay per phase and shorter shift-length options. While staffing issues still exist, leaders continue to work with nurses on ways to address them. - Advocating for nurses and all staff
When the Flexing Staff to Work Volumes Policy went into effect in 2019, it established a process for instances when employees were reassigned or required to take time off, with or without pay, when staffing adjustments were needed based on patient volume and/or department workload. At that time, there was no cap on the number of hours an employee could be “flexed down,” which was a huge dissatisfier. Through robust collaboration with the Staffing and Operations Council and Betsy Clough, chief human resources officer, Rudy was able to advocate for employees across the organization to reduce the number of hours any employee could be flexed annually from 208 to 60 per year. The updated policy went into effect in July 2022.
Support at every level: Defining nursing leader roles
Aniqueka Scott, MPH, BSN, RN, has always had an interest in learning more about different nursing leader roles. So, when she decided to pursue her Doctor of Nursing Practice (DNP) degree, she explored the various levels of leadership through a DNP in Systems Leadership and Innovation practicum.
“This was a unique opportunity for me to evaluate leadership at various levels, see how they differ and how they interact with, support and complement each other,” said Aniqueka, who works on the Family Practice and Forensics Unit at University Hospital.
Through contact with UW Health leaders in meetings, steering committees and workgroups, Aniqueka learned about the oversight responsibility for each role and how it supports nurses.
- Nurse manager: Unit leader who provides oversight for a unit’s nursing operations and transitional care
- Nursing director: Oversees nurse managers and provides operational oversight of multiple units/areas or provides guidance for a particular area such as infection control
- Leader through influence: Oversees departments that support nursing and influence nursing outcomes such as education, quality/safety/infection control and shared governance
- Chief nursing officer (CNO): Provides oversight of a designated facility or services, and the respective nursing or clinic operations directors
- Chief nurse executive: Oversees CNOs and leads strategic organizational changes, including nursing and other departments
Aniqueka recognized two common threads among UW Health leadership roles: A genuine sense of concern for RNs on the frontline and a commitment to serving as mentors. “Not only do these leaders want to share their knowledge, they care what nurses have to say and want to support their roles in any way possible.”
Cultivating professional growth
When Aniqueka and Josh Ernst, BSN, RN, pursued their DNP degrees, they experienced the leadership culture from a new lens.
“UW Health nurse leaders have provided me with substantial support throughout my doctorate studies,” said Josh, who serves as a clinical program coordinator for the Telestroke Program. “With this experience, I learned from various leaders within the organization, and I will take their advice with me wherever I go.”
In one of Josh’s practicums, Melanie Hankes, BSN, RN, nurse manager, UW Health East Madison Hospital Emergency Department, showed him how to overcome unique department challenges by coming up with creative and innovative solutions. “Teamwork is essential and expectations are high,” he continued. “There is always a sustained commitment to our patients, staff and the community. It is nothing short of inspiring.”
What stands out most for Aniqueka is having leaders who believe in her.
“They see my potential, and no one has ever made me feel I was reaching too high or dreaming too big,” she said. “I’ve been supported by every leader I’ve interacted with, confirming my decision to get my DNP.”
Aniqueka said she’s received the same advice from many leaders: Stay curious and keep asking questions. One takeaway came to light when she saw the work that went into establishing the Internal Discharge Lounge that was quickly operationalized by nurses and nursing leaders to help free up inpatient beds.
“I’ll never forget when Michele McClure (chief nursing officer for University Hospital) said, ‘Don’t let perfection get in the way of progress. We didn’t get it perfect, but we were off to a good start,’” Aniqueka said. “That realistic approach — acknowledging the need to evolve — really stuck with me.”
Another notable moment was seeing the humility of the leaders.
“They are down-to-earth and want to hear from frontline nurses to learn how best to support them,” Aniqueka said. “It’s all about teamwork and willingness to have conversations to try and make things better for everyone.”
Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).