Empowering individuals, inspiring teamwork
As the Director of Ambulatory Nursing at St. Christopher’s Hospital for Children in Philadelphia, Pa., Cheryl Clancy sees her role as a vital link in the continuity of care from providers at offsite clinics in the system to those at the hospital itself.
“The outpatient nurses feel like there’s a little bit of a disconnect from what the inpatient nurses do,” she says. “Although they’re working in alignment, they don’t even know it. My passion is to make those who are out there in the clinics feel very much a part of the organization and the inpatient message [so they will] build relationships.”
In the isolation of the day-today routine of various health care specialties, sometimes people “forget to look up and out.” That kind of tunnel vision doesn’t do much to keep folks motivated, current, or striving toward creativity, Clancy says.
“A lot of departments work in silos. [It’s] nobody’s fault. It’s just with how hard we each work in our own departments that we forget to look up.”
Clancy sees her role as “trying to close some of the gaps in the different nursing subsets.” Since her earliest rotation in the NICU at Thomas Jefferson University Hospital in Philadelphia to the completion of her MSN from American Sentinel University and the launch of her teaching career, she has worked to understand how the grind of the nursing profession can imbue bad professional habits after years of work.
“It amazed me that you come out as this new nurse, and you’re taught head-to-toe how to do things the right way, and you look around at your colleagues and see where people start to not do the things from A to Z,” Clancy says.
“I knew I was giving great care to my little babies, but it killed me to look around and see the nurses of 20-plus years who forgot about the simple stuff you should be doing,” she says. “I wasn’t in a position to coach, if you will, my predecessors.”
From that point on, Clancy says, she would make leadership the focus of her professional career. She liked caregiving, but “what drove me was the idea that I could help get better care for everybody” in a role where she could affect institutional cultural change.
For starters, Clancy says, leadership training taught her that the desire to be a leader is not instilled by any formalized training; rather, “leaders are students,” and the desire to improve and be inquisitive about the world is “definitely an informal role that we all have inside of us.”
Leadership can make a difference in the delivery of care in a health setting, Clancy says, by a process of reward and recognition. Formalized programs can change the culture of a hospital, “and if you don’t have a program then you need to have your culture,” she says. If organizational culture is part of the active and normal discussions of the workplace, staff members will feel empowered to speak up and make a positive change, Clancy says.
Clancy says she helps create a positive culture by speaking up when she notices another nurse going above and beyond his or her basic responsibilities. “I would commend that person in public because that’s [also] going to send that message to that person who’s slacking.”
Sometimes it’s as simple as sending a thank-you note. Clancy points out that during her first week at St. Christopher’s Hospital, the maintenance workers who helped get shelves installed in her office made such a difference to her that she marched over to their department supervisor and commended them personally. “They were happy and energetic and helpful,” she says.
“You’ve got a great team of people,” she said to their supervisor. And he said, “Thank you. I know I’ve got a great team, but it’s great to hear it.”
A positive culture change can improve the performance – and the morale – of an entire organization. On one extreme is “the surgeon who’s irate because his cases aren’t starting on time,” and at the other is a housekeeping staffer that can’t clear out patient beds in time. Clancy says if you get your team to be on the same page—and that starts by reminding everyone in the system that they’re part of the same, well-oiled machine—the trickle-down effect is an improvement in patient care.
“What makes it a transformational type of situation is working outside the box,” Clancy says. “You have to be innovative. If I can sell them what’s in it for them…I’ve always said that the buy-in is going to benefit you.” There will always be staff members who “aren’t inculturated or who don’t like change,” but bringing those people into the fold requires an understanding of their perspective—which is the basis of leadership work. Empowering everyone to take an active role in creating a better environment sometimes means just getting to “the rock bottom of what’s causing their angst,” she says.
“I think it comes back to self-reflection. People are good at caring for their patients, [but] sometimes they need a different outlook, a different feeling. That’s why it’s important that we have leadership.
“They can be a nurse for 20 years and do a good job, but the passion is not there,” she says. “Maybe there’s this inside writer that we never knew about. Maybe they like photography. Maybe they forget to capitalize on their other assets.”
“I think more and more nurses are coming out empowered, especially with the proliferation of nursing programs. They’ve already been managers [or] executives. Education is changing to implement more leadership, but I think old-school [thinking dictates that] nurses are a subservient specialty.”
Here’s the one thing she wants all nurses to know: “Understand and know that just because you’re a nursing director [or a nurse] doesn’t mean you can’t be a leader.”