21// It's On You: The Impact of Accountability and Culture on Nursing Career Advancement (Nurses Week Kick Off)

In this episode, I tackle the backbone of career progression in nursing through the concepts of accountability and ownership.
Every nurse has the potential to exert a significant influence in healthcare – it begins with a commitment to personal growth, shedding outdated practices, and setting strategic boundaries. Prepare to be equipped with actionable insights as we dive into the role that culture building plays in nurturing your professional path.

Celebrating nurses isn't just a monthly event; it's a daily practice of fostering self-awareness, emotional positivity, and the relentless pursuit of excellence. 

I break down the Florence Challenge, transforming how we perceive and handle criticism, and turning complaints into constructive growth opportunities. Get ready to be inspired to exceed expectations in patient care and professional fulfillment, as we explore how nurturing a thriving healthcare culture is beneficial, and essential for long-term success.

Transcript

Bonnie Meadows: 0:00

This particular episode is based on a book, and this book really focuses on accountability, ownership and a building of culture. And you may think, well, what do I have to do with that and what does this have to do with growing your career? Well, growing your career is not always about what you're doing in the in-between to get from one point to the next, but it's also about what are you doing in your current work, because you're always interviewing, you're always preparing yourself for the next step. So what are you doing in the current to be sure that you are growing in your current space? You're leaving behind different practices that didn't work for you in your current work or may not be great for where you want to go, because what got you here will not get you there. What got you here will not get you there, and so I want to dig into a lot of that in this series. So we're going to cover things like accountability, ownership, empowerment, engagement and really the culture, like how do we change the culture of nursing? It starts with us individually, and then we will work it out from there and I will definitely make the connections to what does this mean for me in everyday life, to get me to a place of growing in my career, getting career clarity and making an impact.

Bonnie Meadows: 2:26

So I have two master's degrees. My first master's degree is well, both of them are in nursing, but the first is master's in nursing and health systems. Leadership was the focus. That's what they called it. It used to be. It's the same thing as a nursing leadership master's or a nursing administration master's. It's the same thing. And that was the catalyst to help me in my gap of I knew that I wanted to be. I wanted to work in what we called it back in the day be. I wanted to work in what we called it back in the day hospital business, and it's actually a budgeted term. But I knew that I wanted to expand beyond the clinical space and my expansion beyond the clinical space was not it was corporate nursing, but it was. I didn't think of it as that, I just thought of it as I wanted to get involved in data analytics, quality improvement. I'd learned that that was my love. So first master's degree health systems management, and in that program it helped me to shape what I was looking for. It helped me to validate the thoughts that I had about nursing and healthcare.

Bonnie Meadows: 3:50

There was one book that made a huge impact on the way that I saw healthcare and the possibility of how things can work in healthcare, and there are probably outside of the Bible, there are two books that have really had an impact or made an impact on my thought process and helped me to gain more wisdom and clarity and take action in different ways, and so one is the book that I'm going to discuss today, and the second one is called Essentialism, and I will dig into the book Essentialism. Essentialism helped me to deal with the overwhelm that we deal with as nurses in healthcare. It gave me the permission to understand and set boundaries, and that's one of the areas that I would love to cover within this podcast of really helping us to set boundaries, because the lack of boundaries is what causes our overwhelm, because we don't really know what we can say no to. As nurses, we've been taught like once you get to the unit you got patients to take care of, and you can't say no. Like once you receive report, that's it. And then we carry that. We carry that responsibility into everything, even once we are in, I would say, advanced clinical work. Like we have a master's degree, we are still in the clinical space, but we're doing other work in the clinical work. Like we have a master's degree, we are still in the clinical space, but we're doing other work in the clinical space and we carry that responsibility. Because it's our patients, we have responsibility over them, regulatorily, we have responsibility over them. And so essentialism helped me to kind of bring that back into. What does this really mean and what is truly essential and impactful for my own career and for the space that I work?

Bonnie Meadows: 5:49

In the book that I'm referring to today, it's called the Florence Prescription From Accountability to Ownership Manifesto for a Positive Healthcare Culture Stole for a positive healthcare culture. Who would have thought that that could be? So it can. I'm not just dreaming of things. I truly believe that there are some people who are working out there in a positive healthcare culture. I will also say, coming from working in a large system, there are pockets of it. It might not be everywhere, but I've seen pockets of a positive healthcare culture, and so this book really addresses the need to re-spark the spirit and purpose and mission of who we've committed to be in our professional lives as those caring for others.

Bonnie Meadows: 6:50

And I thought it was very fitting as we are going into the month of May, which is usually a celebration of nurses. The ANA has stood in the previous years we were doing a whole month of of nurses, of nursing celebration, and we have now pulled back to just nurses week, back to what we usually and had been doing like. This is a time of reflection and renewing and reviving is what it should be, and really just recommitting to the work as a nurse. This book was also a reminder that holding people accountable for their performance and outcomes is not enough. If you're an ambitious nurse, that has been a frustration of yours, because you just want things to work well around you so that you can do the job that you believe you're called to do, and then we must go beyond mere accountability and foster a culture of ownership, where people hold themselves accountable because they have personal buy inin to the values and missions of their hospital. It's really about being a nurse of like.

Bonnie Meadows: 8:10

The book is about healthcare culture, but what I am here to really hone in on and talk about is nursing culture. We are the largest workforce probably period point blank, but I'm just going to say in healthcare for today, and we make up much of the culture of healthcare. Regardless of whether we want to admit it or not, take accountability for it, we make up that culture, and so how do we become a nurse of excellence and not perfection? And so how do we become a nurse of excellence and not perfection? No-transcript. This book helps with that and it helps you to view others possibly a little bit differently, because you're not taking on things personally. So let's jump into it. So in the book it talks about again the re-spark of our mission, vision and values. And I talk about when you're doing, when you are developing your self-awareness to grow your career. The one thing that you do have to really figure out is what is my mission, what is my goal, what is the vision and what are my values?

Bonnie Meadows: 9:28

This book encourages us to take what they call a Florence challenge, and that Florence challenge reminds us that taking care of the sick should be a mission, not just a business, and being a nurse or healthcare professional should be a calling and not just a job. In my last episode, I talked about the importance of being career-minded and not just job-minded. It impacts your culture and you know that. You know the people who come to your unit, who come to your area, who are really just there to do a job. They're not looking to build a career, to build a career, and so the way they act in that space is different than the way you act when you are career-minded. And so how do we commit to this Florence Challenge? What does that mean? We know what it reminds us of, but what do we actually need to do? And so the Florence Challenge talks about three things.

Bonnie Meadows: 10:39

One, being emotionally positive, by turning every complaint into either a blessing or a constructive suggestion. That's hard. Why is it? Number one? I know it's really hard, but we have to begin to shift our thought process that way, and it doesn't happen overnight. I'm just going to tell you this that does not happen overnight yourself, to understand and to know and to be reminded that this, that I'm trying to stay emotionally positive. I'm trying to stay emotionally positive. Being emotionally positive actually seeps out into other areas. It seeps out. It helps you to think about serving more than it being about you. It's less about your ego and it's more about others. And I'm not saying to lay down and be a doormat, but it's boundaries that allow you to be a better nurse, and by better nurse I mean a nurse who is doing things with intentionality, a nurse who is more compassionate, a nurse who is able to give just a little bit more. You have a little bit more capacity because you've exercised boundaries in the right way, and so that allows you to be emotionally positive. So how do we do that? Here are some quick tips on how to be a little bit more emotionally positive, especially when it comes to criticism and complaints, because we get complaints from patients, we get complaints from our peers, we get complaints from the people that we report to. We get complaints from not just not the people that we report to, but the people that report to. The people that report to the people.

Bonnie Meadows: 12:43

One consider the intent. Many times they don't know you personally and you don't know them personally. So you've got to consider is the intent of this to do the best thing for the patient, or is the intent to harm me or to put me down, or whatever the case may be? And sometimes that's even peer to peer, like we get all in a ruffle because someone has called you out about what you didn't do and it's like, well, what is the intent of the call out? Now, sometimes the intent of the call out is selfish on their part, but is there really something that I could have done that helped this situation, to help it to not have come to a place of they need to criticize me, or is it one of those things of they're just being selfish and they want to criticize because they're not doing their part to exercise boundaries? Here's another way to be able to be emotionally positive Process. Is this relevant or will it help my long-term growth?

Bonnie Meadows: 14:00

I've said before about how there are things that I have been criticized about with my leadership, and it wasn't a bad criticism. It wasn't a good criticism. It was an observation that I could have taken on as criticism, but I chose to look at it as that's not a part of my long-term growth. It's not going to impact my review, it's just a preference of yours. So because it's just a preference of yours and it's not gonna really impact my growth, career growth, then I'm leaving it at the door. I'm leaving it at the door, it's just a constructive suggestion.

Bonnie Meadows: 14:44

And third, consider the systems. I was talking to a nurse one day and she was talking about how she works PRN. But every time she comes in she's getting floated to another area. She works PRN for one area. Every time she comes in, she's getting floated to another area. And so she began to take that on as personal and I said no, that's not personal, you're just a path of least resistance. That is the system that we're working with. So that person comes to you and you're thinking why am I always the one that's getting floated, or why am I the only one?

Bonnie Meadows: 15:23

And it's okay to say something to someone, to say, hey, I'd prefer not to be floated. That's your boundaries, that's activating your boundaries and saying can I please stay on my unit? Now you've at least put your request out there so that you're not playing victim. But the other piece to it is you are falling victim to the circumstances that surround you and the systems that you work within. So we've generally got to just fix the systems, because it's the systems that's causing them to come to you as the path of least resistance. Because they need someone to float here and float there, because you are a PRN worker, and they will more than likely give preference to those who are working full-time or at least part-time. That's just the reality of it. Full-time or at least part-time, that's just the reality of it. Consider the systems. So that is all under emotionally positive, one of the three things that is a part of the Florence challenge.

Bonnie Meadows: 16:24

The next one is to be self-empowered. I would also call this self-leadership, which also includes activating boundaries my gosh, look at that word. But all of these things create a better culture, help you to be a better nurse. Being self-empowered it's taking to heart the seven promises of the self-empowerment pledge, which I will get into. As I've said earlier, this is a series, so that I'm going to get into later, but I will tell you what the seven promises are in the self-empowerment pledge responsibility, accountability, determination, contribution, resilience, perspective and faith. All things that you have to do, not someone else. Why is this important? Because as long as you take care of you, then everything else will fall in line or it will help you to clearly see is it me or is it them, and then you can make decisions based on that information.

Bonnie Meadows: 17:40

So how do you do that? You stay tuned to understand what those seven principles are, but in the meantime, self-leadership really and self-empowerment really is based on you activating boundaries and working on yourself, empowering yourself, not waiting on someone else to lift you up to do Don't wait for help, help yourself. That's really what it comes down to. For help, help yourself, that's really what it comes down to. And then, lastly, being fully engaged. That is a part of the three elements of the Florence Challenge. So, emotionally positive, self-empowered and being fully engaged, those three really help you to be a nurse of excellence and help you to build a culture of excellence where you work. And so being fully engaged means being committed, engaged and passionate in my work.

Bonnie Meadows: 18:46

So what does it mean to really be fully engaged? Taking initiative and being an effective steward of resources, fostering a spirit of belonging and fellowship and taking pride in your work, profession and organization, and yourself and yourself. Why do we do that Like? Why do we need to be fully engaged? Like? We know? But we understand that that's really the only way to care and to give your full attention to your work. To really pull out those pieces of joy and satisfaction that you long for in your work and it's the best way to make an impact is to be fully engaged, even if you've got and fully engaged means lots of things. It doesn't mean doing a lot. It's more about the intentionality in what you do every day. It doesn't mean you need to be on three committees and you need to be working on five projects.

Bonnie Meadows: 19:49

What is the intention in which you work? Are you taking initiative and not just waiting on someone to do something? When you see a piece of equipment that's broken or something that's broken, are you taking initiative to go ahead and just put a sticker on there and call the work order in and tell the charge nurse hey, this is what's going on. Are you taking initiative to make sure that you are having conversations? Those of you who are in my more eight to five positions are you having those conversations? My advanced practice nurses are you having those advanced conversations, those proactive conversations, and taking initiative when you see something's not right with a particular nurse or they need education on a piece? Are you taking initiative to be able to have those frank conversations, not of constructive criticism, but more so understanding, asking questions and then educating. I don't have time for that, okay. Well then you could continue to perpetuate your circumstance, but yet you'll go and talk to the nurse manager about it, when you could have just handled it. So it's all of those things.

Bonnie Meadows: 21:05

So how do we do that? We focus on being clear about and acting upon your personal values in the way you should do at work. So, however you are doing that personally, do it also professionally. So, to recap, we are taking on the Florence Challenge, and we are doing that by being emotionally positive, we are being becoming self-empowered and we are being fully engaged. Why does that matter? Because you want to be a nurse of excellence, you want to make an impact, you want to grow in your career, and it starts with you, because you are the only one that you can really control, like everything else you can't control. So it helps to just kind of say, okay, what can I do? What do I have control over? And then you go from there, and so there are three other elements. So that's a part of the Florence Challenge, but then there are three elements that flow from that Ownership, empowerment, engagement and culture. And so in the next three episodes I'm going to focus on those elements separately. What does ownership look like, what does empowerment and engagement look like? And what does culture look like and how can you be the culture that you want? How can you be the culture that you want in where you work currently and where you're going? Because you can't take that attitude and the lacklusterness where you are and where you're going, you are the culture. Where you're going, you are the culture.

Bonnie Meadows: 22:57

I hope you enjoyed this and I look forward to talking to you about this a little bit more. See ya,