NR 504 Week 8 Leadership Role Synthesis Paper Example

Role Synthesis: Promoted on Your Own Unit, the Hard Part Is Not Learning the New Work but Stopping the Old, and the Colleagues Left Behind Need You to Stop

Student Name

College of Nursing, Chamberlain University

NR 504: Leadership and Nursing Practice: Role Development

Instructor Name

Month Day, Year

Role Synthesis: Promoted on Your Own Unit, the Hard Part Is Not Learning the New Work but Stopping the Old, and the Colleagues Left Behind Need You to Stop

A Claim I Could Lose

My claim is that for a nurse promoted to a leadership role on the unit where that nurse was on staff, the hardest part of the transition is not learning the new work but stopping the old, and that the colleagues left behind are better served by a leader who stops than by one who keeps helping. The claim could be wrong. A reasonable colleague could argue that staff want a leader who stays close to the work, who picks up patients on a short day, who still answers the questions they always answered. The rest of this paper tests the claim against three occasions from my first nine weeks as clinical coordinator on a mother-baby unit, and then gives the objection its full weight.

Occasion One: The Float List

In my first week, a night nurse I had worked beside for six years stopped me at the time clock and asked me to fix the float list, which had been skipping two nurses since they returned from leave. She asked me to "just fix" it, which meant: fix it as a favor, the way a peer would. The old work, being one of the nurses who sorted things out among ourselves, was the thing she was asking for.

I fixed it on the record instead, and told the manager. She was cool with me for a few days. But the rotation has been followed since, because the correction was visible and the manager knows to check it. If I had done the old work, the fix would have lasted exactly as long as I remembered to protect it.

Occasion Two: Three O'Clock on a Thursday

In my fourth week, two nurses called out, and at 1500 the charge nurse asked me to take four couplets. I did, and I was good at it. During those four hours, nobody arranged staffing for the night shift, and it started two nurses short with no plan. Heifetz and Linsky (2002) describe leaders who stay on the dance floor and lose sight of the whole. That afternoon, I was entirely on the dance floor.

The staff were grateful that afternoon. The night staff were not grateful at 1900. The old work helped the people in front of me and hurt the people I could not see. That is the pattern the claim depends on: the old work usually helps someone visible and costs someone who is not.

Occasion Three: The Report I Was Good At

In my ninth week, the monthly feeding report I had handed over came back showing 71% of babies exclusively breast-milk-fed instead of about 57%, because my two-sentence handover had left out the standard I had applied for four years. At eleven at night I started correcting it myself, then stopped. The next day I sat with the nurse who had taken it over and gave her the standard.

Stopping the old work here meant more than handing it over; it meant resisting the urge to take it back when it came back wrong. If I had corrected it alone, the report would have been right in October and back on my desk for good. The colleague who took it over would have learned that the work was not really hers.

What Theory Explains

Role theory explains why the old work keeps arriving. Hardy and Conway (1988) describe role transition as a period in which the expectations of a former role linger in the people around the person who has moved. My September log showed 19 hours a fortnight of requests that belonged to the staff nurse I used to be, work that a coordinator hired from outside would never have received. The expectations are not unreasonable; they are just attached to who I was.

Tuckman's (1965) stages explain what my move did to the day shift, a stable group that I had been part of. When I left and came back above it, the group had to form again around a changed structure. The four-week delay before I heard about an open dispute between two senior nurses suggests that the storming has gone quiet in front of me rather than stopped.

The Objection at Full Strength

The strongest objection is that staff value leaders who are visible and clinically present, and that a coordinator who steps back from the floor loses the trust that made the promotion make sense. That objection is not a straw man. It is what I believed as a staff nurse, and it is what some of my colleagues believe now. Each short afternoon I spend in the office rather than in a patient room, at least one of them will think I have forgotten what it is like.

My answer is partial. I have kept eight clinical hours a week and the clinical skills at the core of the unit's work, so I am not absent. And the three occasions suggest that the trust staff most need from me is not that I will help with their patients but that I will fix things properly, make the night shift safe and give them real ownership of work. But I cannot yet show that this kind of trust outweighs the kind I am giving up. That would take a year of watching whether staff bring problems to me earlier, not nine weeks.

What I Cannot Claim Yet

I cannot claim that stopping the old work has made the unit better. Nine weeks is too short, and the evidence is my own account. I cannot claim that my experience applies to leaders promoted from another unit or hospital, who bring no old work with them. And I cannot claim that stopping is always right: some afternoons a patient's safety will depend on my taking patients, and the claim gives way to that.

Ninety Days With Dates

By November 7: the new lactation resource takes all daytime pump and latch calls; my old extension forwards to her.

By November 21: the January to March schedule posted, built by me and reviewed by the manager.

By December 5: meet separately with each of the two senior nurses about discharge teaching.

By December 19: lead the December staff meeting, including a two-minute item asking staff what small problems they have not raised.

By January 16: a joint conversation with both senior nurses, ending in a written agreement.

By January 30: review with my mentor how many problems reached me within a day of the floor knowing, compared with September, as the first rough test of the claim.

References

Hardy, M. E., & Conway, M. E. (1988). Role theory: Perspectives for health professionals (2nd ed.). Appleton & Lange.

Heifetz, R. A., & Linsky, M. (2002). Leadership on the line: Staying alive through the dangers of leading. Harvard Business School Press.

Tuckman, B. W. (1965). Developmental sequence in small groups. Psychological Bulletin, 63(6), 384-399. https://doi.org/10.1037/h0022100