From vision to action: Discover the Nexus

To what degree are you contributing to the vision and reality of interprofessional practice and education? To become a part of this national and international movement, explore the resources and activities of the National Center for Interprofessional Practice and Education (the Nexus). If you are already involved in interprofessional practice and education, you should definitely consider registering and becoming a part of the growing Nexus network. The story of Amina best represents the vision of the national center in advancing a desired future for practice and education in the health professions.

People Images/iStock

Recently, I had the opportunity to facilitate a national conference hosted by the Nexus. More than 100 people from around the United States who are part of the national center’s Innovation Network came to Minneapolis to share stories, insights, and results of ongoing initiatives related to the movement. Drawing upon a variety of liberating structures, participants engaged in dialogue and shared learning about their individual projects, challenges, and issues. The social networking and cross-pollination of ideas, experiences, and lessons learned fostered additional innovations and insights among conference participants.

The center is supported by Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067 with major funding from the Josiah Macy Jr Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, and the University of Minnesota. If you are looking for resources and ideas to advance research, teaching, or partnerships in interprofessional education and practice, explore the center’s website and go to the Nexus Learning System or Resource Center links to learn more and connect with others.

One of the most exciting aspects of the center’s work is the creation of a National Center Data Repository (NCDR) that will support comparative effectiveness research about the value and promise of interprofessional practice and education efforts to meet the triple aims of high-quality patient experiences, improved population health, and lower costs. As the center continues its work and learns over time, it will be an example of an organization turning vision into action.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Values in conflict? View your organization through a CVF lens

Robert E. Quinn, PhD, is one of my favorite leadership scholars. One of his significant contributions to the field of organizational studies and leadership development is the competing values framework (CVF). The CVF helps one make sense of the tensions people often experience in organizational life.

As noted in this video introduction to the CVF, individuals and organizations are continuously challenged to manage polarities that relate to external positioning and internal maintenance, as well as flexibility and control. The juxtaposition of these competing tensions creates different types of organizational cultures, which are animated by values associated with framing and focus. Simply put, these frames and focuses involve collaborating, creating, competing, and controlling. Which of these four values resonates personally and professionally with you?

— Dolgachov/iStock/Thinkstock

Gaining insight into these tensions helps one appreciate and value differences between and among people and processes in an organization. Such appreciation leads to development of compassion and respect for individual contributions to the organization. Using the lens of CVF, how would you describe the culture in your organization?

Three levels of analysis
Given the competing values framework, there are three levels of analysis that help one gain insight. At one level, organizations are analyzed relative to external outcomes and expectations. At another level, competing values in terms of an organization’s internal workings are analyzed. Finally, at the third level, how the framework relates to individuals in the organization is contemplated. Knowledge and understanding of CVF provides leadership insights and guidance about how to navigate tensions and issues and support alignment of people with organizational processes, purposes, and effectiveness (Cameron, Quinn, DeGraff, Thakor, 2014).

For example, if an organization is focused on internal maintenance and stability, the culture is probably hierarchical and its orientation one of control. Leaders in this type of organization focus on coordinating, monitoring, and organizing. Value drivers are efficiency, timeliness, consistency, and uniformity. By contrast, if a culture is focused on external positioning and is flexible, it is an adhocracy, and creativity is valued. Leaders in this type of organization are innovative, entrepreneurial, and visionary, and value drivers are innovative outputs, transformation, and agility.

In a market-driven culture, the focus is external positioning, stability, and control, with competition the orientation. Leaders in this type of organization are hard driving and competitive. Value drivers in a market culture are market share, goal achievement, and profitability. A fourth culture type is clan. In this culture, the focus is internal maintenance and flexibility. Leaders in this culture are perceived as facilitators, mentors, and team builders. Value drivers are commitment, communication, and development of people and relationships.

In successful organizations, the competing values of collaborating, creating, competing, and controlling are at play concurrently. Consider the conflicts that can erupt if leaders and managers in an organization have a competitive market-driven focus and workers adhere to a clan or collaborative focus. Or how does one manage tensions between a need to be creative and innovative while, at the same time, working in a hierarchical bureaucracy? Or how does one both compete and collaborate?

How about your organization?
As you reflect on your organization, how does competition among the competing values of creating, competing, controlling, and collaborating play out among leaders, managers, and staff? With your personality, traits, and behaviors, what role, from a competing values perspective, do you play in your organization? Are you a pioneer, networker, achiever, strategist, anchor, analyst, team player, or helper? How can you leverage your strengths and role to make a positive difference in the organization’s culture and milieu?

As a result of learning more about the competing values framework, I have developed more compassion for and insight into the dynamics of academic and health care organizations, and this has enabled me to positively influence change and transitions. I invite you to learn more about the framework, and apply leadership insights you gain to the culture in which you find yourself. Developing a competing-values leadership skill set will enable you to maximize, influence, and activate your own success, as well as the success of your organization.

Reference:

Cameron, K.S., Quinn, R.E., DeGraff, J., & Thakor, A.V. (2014). Competing values leadership. Northampton, MA: Edward Elgar Publishing.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Influence, power, and activism

There is focused effort to get more nurses on governing boards. The goal is to have 10,000 nurses serving in that role by the year 2020. There is no doubt that nurses have much to offer in terms of knowledge, skills and experience, but many are apprehensive about issues of influence, power, and activism.

I continue to be perplexed by the paradox that, although nursing is ranked consistently as one of the most respected professions, nurses are not regarded as being very influential. What does it take for nurses to own and master their influence skills? Eleanor Sullivan, PhD, RN, FAAN, a past president of the Honor Society of Nursing, Sigma Theta Tau International (STTI), tackles this issue in her book Becoming Influential: A Guide for Nurses, 2nd edition (2013), Prentice Hall, Boston, MA. In "Taking the Mystery Out of Influence," Sullivan advises reading the subtext of situations and going beyond the non-verbal to gain influence insights. Suggesting that professional presence supports influence consciousness, she notes that power is a foundation for influence. Perhaps nurses need new ways to think about the powers they possess?

Six stages of power
Janet Hagberg’s model of personal power is a useful guide for reflecting on the dynamics of what she identifies as the six stages of power: 1) powerlessness, 2) power by association, 3) power by achievement, 4) power by reflection, 5) power by purpose, and 6) power by wisdom. She believes there is a developmental trajectory to these stages and that people grow and evolve from one stage to another. She describes the characteristics of each stage, where people can get stuck, and how a person can move forward from stage to stage. 

mindscanner/iStock/Thinkstock

Observing that individuals can be, at any particular moment and relative to other people, at various stages of power, Hagberg links these stages to issues of leadership and motivation. Using her model and reflecting on one’s own developmental progress in regard to stages of power leads to insights and understanding of self and others. I personally believe that, to be effective and successful as a governing board member, power by reflection, power by purpose, and power by wisdom—stages 4, 5, and 6—are required.

Armed with influence, empowered nurses activate leadership skills. As Karen Kelly, EdD, RN, CNAA, BC, notes in “From apathy to political activism,” published in American Nurse Today (2007), there is a developmental trajectory associated with activism. It moves from apathy to buy in to self-interest to acquisition of political sophistication to leading the way. There is an emerging community of people who are becoming health activists and there are great stories about nurse activists. To prepare nurses to serve on boards, we need to do a better job of helping them own their influence, master their power, and be better activists, particularly at the grass-roots level.

What are your current beliefs and values in regard to the triple helix of influence, power, and activism? Where are you developmentally on the journey from powerlessness to wisdom? What are the compelling issues that ignite your reflection, purpose-power, and wisdom? How will you contribute your leadership talents to a nonprofit or for-profit organization that is meaningful to you? How will you move beyond apprehension to confidence? On what governing board will you serve? Will you be one of 10,000 nurses who serve on a board? The year 2020 is not far off.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.