Registed Nurses' Association of Ontario

Developing Transformational Leadership Practices: Building Relationships and Trust

Tashynna Nault RN & Teresa Tibbo RPN
Parkview Manor Health Care Centre

Summary of Fellowship
Our ACPF was in the Skill Development Stream: Leadership (Management). We had a very unique experience as our proposal was to have a Registered Nursing and a Registered Practical Nurse partnering to complete the deliverables. We were very fortunate to have our proposed ACPF accepted and the mentees worked together to engage in twice the learning opportunities. We had an incredible mentor, Mary-Lou van der Horst, who has been extremely influential in helping both Tashynna and Teresa look at their leadership styles in a whole new light.

Tashynna had the privilege to enroll in the Leadership Program through Conestoga College, a 180 hour accredited course. Which provided education and tools to reflect on her own leadership style and strengths while learning how to adopt this new leadership style to better lead her team. Teresa worked with the RNAO Best Practice Guideline “Developing and Sustaining Nursing Leadership BPG” as well as the book titled “Strengths Based Leadership” by Tom Rath to enhance her understanding of what it takes to be an effective leader and how to implement changes in her practice based on using staff’s individual strengths and understanding what motivates them. She had the privilege of completing a two day site visit to a LTC home that is thriving thanks to adopting servant style and strengths based leadership where she came back revitalized and ready to create positive change.
Through education and discussions with our mentor, we realized that to be effective leaders, we needed to first repair and build trust. We worked closely with our management team (herein referred to as leadership team) to strengthen our relationships and build a network of individuals in the home working towards the same goal. We included these individuals in our leadership education provided by our mentor to ensure that we could move forward as a cohesive team with similar goals and one vision to ensure the work Tashynna and Teresa were doing to hone their leadership skills would be sustained after the ACPF was complete.

Our overall learning goal was to gain skills in strengths based and transformational leadership, reflect on our own leadership skills and inspire each team member to reach their full potential so they may understand their own leadership capabilities. We understand that each person has the ability to lead others, but sometimes you need to shine the light on what a person is capable of before they can see it themselves.

Through this ACPF, we have learned that by building trust you can start a relationship with staff that has never been developed before. Surveys were created for staff which helped us identify barriers and facilitators to change. These surveys gave us powerful information about their experiences with which we could go forward and make positive change that would be truly meaningful not only to these staff, but to the residents as well. For example, we are now going to look more closely at each staff person’s strengths and take the time to help them develop a goal for themselves within the organization that will have a positive impact on the residents and the culture of the home. We have learned that to have staff trust one another, there needs to be a culture of safety and trust within the multidisciplinary team.

We also took the opportunity to survey our residents to identify their preferences about everything from personal hygiene and meals to how they truly wish they could spend their free time. This has helped the leadership team look at our residents through a different lens; the lens that each individual who lives with us looks through each day.

We have learned to take a step back and look at each staff as individuals with their own unique talents and strengths. We now know that each person has something special that they can contribute if we as leaders take the time to work with them and let their true talents shine, showing them that we want them to be successful and engaged at work and beyond. For Tashynna and Teresa to be effective leaders, we must build that trust and relationship with our leadership team so that the team can effectively lead the entire staff with the same principles, ideals and vision in mind. Staff observing the leadership team functioning as a cohesive unit may enhance their trust and allow them to be more open to new ideas and discovering what strengths they themselves are holding onto.

Outcomes of Fellowship

Resident outcomes
The resident outcomes from our ACPF are difficult to articulate as these outcomes may not be fully realized for quite some time. Leadership is not something that can be rushed and not something that impacts resident care immediately; it occurs over time as knowledge and skills are learned, attitudes changed and when staff are encouraged to use their skills to their full potential. This is when we will see the change in our resident outcomes. When staff feel fulfilled, know that their work is valued and are invited to contribute their talents to their full extent, residents will see a side of staff they have never been able to see and relationships will grow and flourish. Each person on the leadership team has set goals and is accountable to another person on the team for follow through. Some of what we are working on currently is described below.
One of the outcomes for our residents that is directly related to this ACPF is the initiation of “I statement care plans.” This is a beautiful way to capture a residents’ story, not just of what ails them, but what brings joy and meaning to their lives in the past, the present and looking towards the future.
Another outcome is flexibility and “thinking outside the box.” How can we meet the needs of our residents in all aspects of their care while adhering to their preferences and desires? One idea the leadership team is discussing is called “flex lunch” where residents would come and go as they like for lunch rather than at a set time. According to our resident surveys, many residents are not particular about lunch and not concerned about eating in the dining room for a set time. This is one strategy we may trial to let the resident the way to their care and services.

Our programs department is going to revamp their schedule and programs as it was again identified in the resident survey that many of our residents prefer to do 1:1 activities. Our programs manager has a goal to make the offered programs more tailored to the desires of the residents and less to the goals of the facility or other outside influencing bodies.

Staff outcomes
Staff outcomes too will be more apparent in the future as Tashynna and I continue our work with the Leadership team. Thus far, we have empowered staff to be honest about what they feel is positive about our home and what they think we need to improve upon as a leadership team and the organization as a whole. Staff being invited to participate in 1:1 interviews with our mentor gave us tangible, valuable information to begin the process of improvement. Staff readily shared their feelings and observations in hopes of making a difference for the lives of our residents. They were also given surveys on change readiness which provided the leadership team with information on just how much work we have ahead of us to help staff feel prepared and ready to accept change.

Tashynna and I are passionate about improving our leadership skills and we talk about our strategies not only with the leadership team but with the rest of the staff. This in itself is helping us to build trust with the entire team as we are being transparent about the journey through this ACPF. When we talk about strengths, we are now starting to include the language in our day to day conversations with staff. In this way, they are hearing the terms and being recognized for strengths they may not have identified themselves. We are introducing the idea of strengths at meetings where we have asked staff to look at the person beside them and tell this other person what strength they see and admire in this individual. This will help to boost self confidence and the understanding that every person has strengths and skills that we can all appreciate and leverage off to improve resident care, staff satisfaction and morale.

So often staff feel employee performance reviews focus on the negative aspects of their work, or areas that they should improve upon. Thanks to this ACPF, we are putting the emphasis on identifying strengths and aspirations in each person. We will work with each staff to help them use their strengths to better the lives of our residents and improve the culture of the home through encouraging creativity. We will ask each staff to come up with an idea of what they would like to do in the next year, the project can be big or small; something that is theirs to accomplish in partnership with the residents. We want staff to feel comfortable sharing their phenomenal ideas so that we as the leadership team can help them bring these ideas to life through time and resources as well as support and encouragement.

Overall Experience
Being able to take the time to learn about our own leadership strengths and styles and reflecting on how these impact our residents and staff has been a powerful opportunity. We have learned many aspects of what leadership means and been provided with tools to assist us in molding ourselves into better leaders. We have been given opportunities to learn from outside sources where these techniques have been trialed and proven successful such as Teresa’s site visit to another LTC home. The opportunity to learn first hand from this team of professionals and residentswas extremely inspiring and beneficial to our outcomes thus far on our leadership journey. We feel so fortunate that this home continues to be a support and resource for our home now and in the future.

This ACPF has been focused on finding our strengths but also helped us to look at our coworkers in a new light and to imagine what it could be like if we truly used each person’s strengths to their full potential. This ACPF has inspired us to continue the work that has really only begun amongst our leadership team, the entire staff and our residents. If staff are highly motivated and feel valued, they will shine and so will the care they provide. The relationship building that we envision is what will keep us going on the journey to leadership transformation.

The beauty of this ACPF is that we were able to reach out to outside sources to help us see ourselves, each other and our home through a different lens. The leadership team has renewed focus and is working on building trust not just within this team, but with the entire staff and residents. Tashynna having the opportunity to participate in the leadership program has provided her with an entire network of individuals to draw from and learn with. They are able to share stories of success, frustration and everything in between as they work through the leadership program together.

The ACPF experience has been inspiring and motivating. When you learn about others who have successfully created positive change as a result of putting the focus on leadership, you get the feeling that you will be able to achieve the same. Having a mentor to help ensure you meet all of your deliverables, stay on the right track and guide you through some of the tough times is invaluable.

We may all take different steps to do a task, but it’s not about the steps; it’s about the outcome and in this case, the outcome is engaged staff and happy, fulfilled residents.