Adel Harb R N*
Visiting Professor Assistant, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and Formal Director of Nursing Education, Security Forces Hospital, Riyadh, KSA
*Corresponding Author: Adel Harb R N, Visiting Professor, Assistant, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and Formal Director of Nursing Education, Security Forces Hospital, Riyadh, KSA.
Received: February 19, 2019; Published: March 05, 2019
Citation: Adel Harb R N. “Developing Charge Nurses as Front Line Leaders through Transformative Learning”. Acta Scientific Paediatrics 2.4 (2019):10-14.
Nurses at all levels must be prepared and developed to lead change to advance health care. Historically, in most healthcare institutes, nursing leadership development programs have focused on nurses in senior management or executive roles rather than those working in front-line leadership roles. This article will describe a professional development initiative program attended by 169 charge nurses. The program has a comprehensive curriculum and road map for developing frontline leaders and ensuring charge nurses are trained, mentored, and supported in their roles. Program development, evaluation, and lessons learned that can be applied in other organizations are discussed.
Keywords: Charge Nurses; Frontline Leader; Professional Development
Succession planning is a concern in healthcare organizations. When seeking to fill Nurse Manager Positions, nurse leaders often consider their charge nurses as excellent potential candidates [1]. Managers and unit level leaders are keys to health organizational success [2]. Both the complexity of healthcare delivery and the responsibility placed on charge nurses have also increased. Increasing patient’s admission in the hospital requires front line leaders (Charge Nurses) to understand their roles, responsibilities and accountabilities, thus they should be professionally developed to enhance their leadership and managerial knowledge and skills.
Most of Healthcare Organizations believes that Charge Nurse is placed by default based on how long they had worked in the unit and who was on the schedule rather than as a result of deliberate planning and scheduling based on who was most prepared to lead the team but it was found that there was a degree of bias and favoritism.
Recently, the Charge Nurse Role is considered as front line leader and most of the hospitals had clearly stated their job descriptions and criteria that are but not limited to qualifications, experience, performance and communication skills. Furthermore, there are few hospital cited in the literature who are developing their charge nurses through a structured professional development plan.
Nursing Department at Security Forces Hospital Program, Riyadh, Kingdom of Saudi Arabia had initiated this project on late 2014 and it was on Dec 2016 when the project was completed. The steps and phases of this project are highlighted in this article.
The purpose of this professional development qualitative project was to prepare qualified nursing staff with sufficient managerial knowledge and skills that will enable them functioning efficiently and professionally in the clinical area. The professional development project adopted Transformative Learning Theory [3].
Charge Nurse Course had gone through several phases: Need Assessment, Preparatory phase, constructing the Course curriculum, Piloting phase, Conduction phase, Evaluation and Measurement phases
The purpose of the NA in this project was not to document that education is needed. Instead, the focus of the NA is to examine what learning strategies would best fulfill the regulatory requirement or help the learner develop the requisite skill.
Nursing Department had identified a void in the Charge Nurse Position and subsequently, had decided to introduce the Charge Nurse Position on Dec 2014. Charge Nurse Position was announced to all nurses on 21st Jan 2015 through an email that was circulated to all staff indicating the inclusive criteria of the staff who are interested.
All Candidates were asked to set for individualized interview with their respected Head Nurse and Clinical Nurse Specialist (CNS). The interview aimed at challenging their knowledge and skills for the new role. All Candidates were preceded to a Pretest organized by Nursing Education. The pretest aimed at identifying the threshold of the knowledge they had in order to prepare the Charge Nurse Course Modules. The Nursing Administration at this phase was engaged to ensure that the Job Description is approved and the Organizational Structure had been adjusted to accommodate the new positions.
Total of 247 staff nurses who met the criteria were set for interview and Pretest. Mean (Average) of Interview = 7.87/10 while Mean (Average) of Pretest = 5.75/10
Table 1
*Difficulty %: was defined as the percentage of wrong answers for each question.
Figure 1: *15 Questions (pretest) and their difficulty percentages
Results were scored and analyzed by Nursing Education Department then reported to the Nursing Administration. Candidates were selected according to Interview Results, Pretest Results and Available vacant Charge Nurse Position in the staffing database. Total of 169 staff out of 247 were approved to proceed to the next step (Attend the Charge Nurse Courses).
Course was developed based on the Literature search (available evident based content and curriculum), Nursing Administration shared experience, Interview results and Pretest.
The Course proposal was submitted for approval by Nursing Administration. The Course proposal consists of: Aim/objectives, Modules, Timetable, Teaching methodologies, Speakers, References. The course was approved by Saudi Council for Health Specialties with 14 CME hours. The main objectives of the course were:
Total of 169 nurses were considered as candidates. Venue was identified. Pilot Course was conducted over 1 day on 2nd Aug 2015. Candidates were asked to evaluate the speakers, learning environment and the contents. The subsequent courses were scheduled and conducted over two days due to facts that major concern by participants and Speakers was that the course is too congested and they recommended to be conducted over two days and furthermore, It was very difficult to apply the Transformative Learning Theory over one day.
The course had focused in its curriculum on the following modules: Leadership, Safety and Quality, Communication and Basic Management (Coordination and Delivery of Patient Care). The course was scheduled in the following dates:
Total of 169 Charge Nurse Candidates had successfully attended the course.
Figure 2
In order to meet the objectives of the courses and to be consistent with the Transformative learning theory, the following teaching methodologies were utilized:
Transformative Learning Theory [3] was enacted through
Learner must learn together through discourse by analyzing related experiences to arrive at a common understanding [4], this was enhanced through reflective practice sessions, role play and group discussion. Furthermore, during selection of the candidate for each course, Nursing Education had considered to register one candidate from each clinical area in order to ensure that the transformative learning and discourse will be implemented in an efficient manner. Moreover the results of the pretest and interview were utilized to develop the curriculum (engaging the participants in identifying the gab).
Figure 3: *Engagement in learning Model (transformative Learning, Mezirow 1997)
There were three evaluative tools used in the project.
Pretest and Post test results were considered and accordingly the scientific value was calculated. Overall report was submitted to Nursing Administration and all candidates had received their recognition Certificates with 14 CME hours.
Figure 4: *Scientific Value = Posttest overall scores--- Pretest Overall Scores= 7.83-5.75/10= 21%
Measuring the effectiveness of the course was conducted through:
It was recommended to continuously monitoring/supporting the charge Nurses in order to enhance the knowledge and skills and prepare them to be developed as future Head Nurses.
This program is developed to meet the educational needs of frontline nursing leaders. The effect of this program has been multifold, as each charge nurse has a sense of purpose, is aware of the expectations and also has specific guidelines to follow. Furthermore, the program will assist the charge nurse to set up plan to succeed, and confidently embrace the charge nurse role [5-14].
Charge Nurse Courses were developed as educational series (Professional Development Project) adopting Transformative Learning Theory as one of the learning theories that is recommended to be utilized for adult learners.
Special thanks and appreciation to the Nursing Administration, Head Nurses and Clinical Nurses Specialists who participated in initiating, conducting and completing this professional development project.
There are no conflicts of interest.
Copyright: © 2019 Adel Harb R N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Open Access by
Acta Scientific is licensed under a Creative Commons Attribution 4.0 International License
Based on a work at https://actascientific.com
ff
ff
© 2024 Acta Scientific, All rights reserved.