Running head: NURSING PRACTICUM PAPER
Nursing Practicum Paper
Marie Wendt
Ferris State University
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Abstract
Stepping into leadership positions as a new nursing administrator is challenging. A learning
practicum provides the nursing leadership student with a formal process for strengthening skills
which require developing. This practicum paper identifies the author’s deficiencies in nursing
administration skills and developed a structured learning practicum for developing them.
Through project development of a nurse manager orientation at a mid-Michigan hospital, the
author identifies activities which encourage the development of needed skills to accomplish the
deficit in four identified American Nursing Association (ANA) Scope & Standards for Nursing
Administrator competencies. Theoretical frameworks and evidence based literature was
reviewed to substantiate activities included in the learning plan. Preceptorship by an executive
nurse and structured evaluation using Bloom’s taxonomy were identified as key components to
assess success.
Keywords: Competency, development, leadership student, nursing administrator, nurse
leader, nurse manager, orientation, practicum, standards
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Nursing Practicum Paper
Stepping into leadership positions as a new nursing administrator is challenging.
Preparing for such a role through academia bestows the rationale and theory for successful
decision making. Performing a learning practicum in a clinical setting allows the novice leader
opportunity to demonstrate teachings in a structured format. This paper provides the detail of
how the author will personally improve nursing administrator skills and abilities of four selfselected American Nursing Association (ANA) Scope & Standards for Nursing Administrator
competencies, with guidance from a preceptor at MidMichigan Health (MMH)-Midland by
initiating a project for nurse manager orientation. It will also review best practice literature,
provide a structured learning plan and an evaluation method for achieving the stated goals
contained within the learning plan. The ANA Standards that are being exercised for the learning
practicum are #4, Planning: The nurse administrator develops a plan that prescribes strategies
and alternatives to attain expected outcomes, Standard #5, Implementation: The nurse
administrator implements the identified plan, Standard # 8, Education: The nurse administrator
attains knowledge and competency that reflects current practice, and Standard # 9, Professional
Practice Evaluation: The nurse administrator evaluates own nursing practice in relation to
professional practice standards and guidelines, relevant statutes, rules, and regulations (American
Nurses Association [ANA], 2009, p. 28, 29, 36, 37).
Learning Plan
In an effort to successfully improve administrator skills a learning plan was developed,
based upon the four ANA standards. The overall learning project centers on creating a nursing
specific orientation plan for nurse managers at MMH, while featuring the standards that the
author sensed were areas that needed to be strengthened for herself. The learning plan’s
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competencies and learning outcomes were determined in reference to the ANA Scope &
Standards for Nursing Administrators and the American Organization of Nurse Executives
(AONE). The ANA standard, Professional practice evaluation was selected to help the author
understand professional practice in leadership procedure and decide the focus of the project for
the practicum learning plan. Planning and Implementation were chosen for the reason that
previous leadership experiences did not allow her to devote herself to formal processes to be
successful with project development and execution. Education was chosen, as the author needs
to understand the most recent best practices in order to lead others in their understanding and
foster buy in from the team for the project completion and success. Evidence based practice
(EBP) was utilized from sources within the last five years to support the activities to achieve the
learning outcomes. The learning practicum will take place September through December 2015.
It is the author’s expectation that the learning plan will structure the learning and development of
the skills needed to be a successful leader. To view the learning plan please see appendix A.
A Review of the Literature
An examination of the literature was performed to determine best practice activities to
develop the learning plan and support the practicum. According to the ANA, the nurse
administrator is defined as a nurse who coordinates and influences the efforts of others in a
designated department (2009). The question must be asked, how does the nurse prepare for such
a role in order to be successful? As there are varying degrees of preparation, including in some
instances very minimal, the novice nurse manager’s ability to effectively lead in today’s
healthcare system has long been in question. Since nurses are familiar within their clinical work
areas, oftentimes highly skilled bedside nurses have been promoted with the thought that a good
staff nurse equates a good nurse manager. However, newly appointed nurse managers have
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demonstrated a lack of skill in regards to the competencies set forth by the ANA Scope and
Standards of Practice for Nursing Administration and the AONE. This literature review sets out
to determine the educational gaps for new nurse managers, as well as seeking innovative
opportunities for achieving the author’s improvement in nurse manager competencies of
planning, implementation, education and professional practice evaluation.
Electronic databases utilized for the traditional literature review included: CINAHL,
Cochrane, OVID, Pubmed, and Google Scholar. Keywords employed included: competency,
coaching, development, leadership, mentoring, nurse leader, nurse manager, orientation, and role
development. A total of 45 evidenced based articles were retrieved. Fifteen articles were
selected for review of the topic. There were limited articles within the last five years which
incorporated intra-hospital based orientation programs for middle leadership. Therefore, one
additional article was included from the last six years to be able to compare and contrast internal
and external programs.
Current Issues in the Literature
For the learning practicum it is important to compare and contrast research outcomes
related to nurse manager skill development. Within the last decade, there have been efforts set
forth to delineate the educational needs for the nurse manager in an effort to define a competent
leader. The ANA Scope and Standards of Practice for Nursing Administration were published in
2009, and provide detail for what competence means for the nurse leader. In addition to this, the
AONE provides competencies related to communication, knowledge, leadership, professionalism
and business skills ("AONE Nurse Executive Competencies," 2005). Despite having access to
these competencies, many organizations are unprepared for operationalizing them when
attempting to develop new leaders. At the same time, novice leaders are expected to be
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proficient in them. The learning practicum will demonstrate competence in accordance with the
ANA Scope & Standards of Nursing of Planning by developing and implementing an orientation
process for new nurse managers that will better prepare them for the role.
The lack of structured nurse manager orientation models or programs is consistently
defined in the literature. Literature further confirms the promotion of unprepared bedside nurses
to leadership roles. Unlike staff nurses who fill general orientation classes in healthcare
organizations and often have structured processes, the nurse manager is usually hired
independent from others. Resources to hold formal in-house education classes are costly for the
few managers in number (Omoike et al., 2011). In addition to this, organizations that do have
general orientation programs for leaders they are not specialized for nurse manager’s unique
requirements (Fennimore & Wolf, 2011). The learning practicum supports the opportunity to
focus on the economic and financial management as set forth by the AONE when planning and
developing the new orientation plan for the few nurse managers in number.
The literature points to the need for improved educational models for novice nurse
managers in order to successfully lead in today’s healthcare environment. Over the last decade
there has been significant changes in healthcare which signify great challenges for the
unprepared novice nurse manager, including patient acuity, reimbursements and digital
technology (Fennimore & Wolf, 2011). According to the ANA Scope & Standards of Nursing
Administration, nurse leaders are expected to be competent in economic influence for the
decisions they make in their role (2009). If this is not achieved it could have significant impact
on the reimbursements for the departments, as well as the organization in which they lead.
Another financial consideration for achieving nurse leader competence is the return on
the investment of nurse manager specific programs for healthcare organizations and retaining
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qualified manager. This can be justified with the reduction in staff turnover, which have direct
and indirect costs equaling approximately $85,000 in 2007 (Fennimore & Wolf, 2011). Other
possible returns on investment from successful completion of formal leadership courses are
improvements in patient quality and reimbursement outcomes (Fennimore & Wolf, 2011).
During the practicum the author will determine financial impact and turnover rates of nurse
managers at MMH in an effort to gain support for the cost benefit during program development.
Aside from the financial pressures, the role of the nurse manager is one of the most
difficult in healthcare. The role is seen as stressful and for one in constant flux (Digman et al.,
2012). It has been identified that unprepared nurse managers often lead by trial and error
(McCallin & Frankson, 2010). Therefore, it is vital for the novice nurse manager to develop the
necessary knowledge, skills and attitudes to lead successfully. There appears to be no consensus
on how to do this. However, there are benefits for healthcare to incorporate such programs. As,
effective leadership for nursing middle management has been shown to improve safe patient
outcomes and quality of care (Vitello-Cicciu, Weatherford, & Gemme, 2014). Despite this, there
is an obvious absence of adequate preparation for nursing managers, lacking structure to develop
and mentor the set forth competencies (Fennimore & Wolf, 2011). Structured programs are
needed to prevent this disparity. The learning practicum will focus on demonstrating the ANA
standard #8 of Education for facilitating educational offerings based on best practice of
preparation for nurse managers. According to the AONE, it is the responsibility of the nurse
leaders to collaborate and maintain academic relationships regarding the future of nursing and
healthcare (Nurse executive Competencies, 2005). The learning practicum will also provide this
opportunity by seeking the prospect to collaborate with local colleges and universities in
developing and providing the needed education.
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Although academic institutions are now incorporating competency teachings into
curriculums, new nurse managers generally do not have this education prior to accepting a
leadership position. When the bedside nurse accepts the role of the nurse manager, the
expectation is that they immediately become project manager, an expert in human resource
management, budget expert, quality analyst, risk manager, compliance manager, mentor and role
model (McCallin & Frankson, 2010). According to Shirey et al., these unrealistic expectations
can lead to damaging results for healthcare (McCallin & Frankson, 2010). Fortunately, the
administrator expectation concepts are often included in curriculums in advanced nursing and
business degrees. However, advanced nursing degrees are not usually required for nurse
managers in many organizations (Omoike, Brooks, & Loyd Storfjell, 2011) which adds to the
disparity. It has been reported in 2003, 84% of nurses who hold executive positions in the
United States have Masters Degrees, whereas, 31% of nurse managers have attained them
(Digman et al., 2012). According to the Coalition of National Nursing Organizations, these
Master’s Degree programs encompass the fundamental competencies for leadership (Digman et
al., 2012). This further demonstrates the need to develop orientation programs for when they
step into the managerial role.
Literature Findings
The learning practicum includes conclusions from evidence based sources. It can be said
that leadership development programs hypothetically improve novice nurse manager skill with
competencies set forth by the AONE. In an effort to demonstrate this concept the Organization
of Nurse Leaders of Massachusetts and Rhode Island developed a nurse manager orientation
program which comprised of four classes over a two month period. Faculty were recruited from
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the Organization of Nurse Leaders national chapter and employed group sessions, case studies,
project management, mentoring, reflecting and journaling (Vitello-Cicciu et al., 2014).
Qualitative data demonstrated nurses expressed behavior changes in the areas of self-awareness,
self-regulation to manage, being emotionally aware of others, seeking diverse feedback,
engaging in active listening, and having crucial conversations (Vitello-Cicciu et al., 2014). This
study expressed the belief that nurse managers experienced positive behavior changes after
attending a structured orientation program. The number of participants were few and the
responses were anecdotal in nature. Larger studies are needed to display repetition in results. In
addition to this, a more structured evaluation process elicited from nurse manager’s supervisors
would add value to the study results.
One distinction that is made in the most current literature is the need to collaborate with
outside entities to develop nurse manager orientation and competency development. This
appears to show strength in today’s economically challenged healthcare organizations. Having a
collaborative concept shares the expense for the greater good of all. The University of Pittsburgh
Medical Center (UPMC) Leadership Development for Nursing Middle Managers program
enlisted nurse executives, faculty from the university and graduate prepared human resource
experts to teach five full day sessions over two months (Fennimore & Wolf, 2011). It is
beneficial to have experienced presenters from university faculty, human resources whom are
graduate prepared, and internal nurse executives (Fennimore & Wolf, 2011). The curriculum
included activities such as reading evidence based literature, self-assessments, lecture, group
discussions, and assignments to apply and reflect learned material (Fennimore & Wolf, 2011).
Structured reflection can take many forms such as centering, journaling, and affirming (Chinn &
Kramer, 2008). Managers who completed the course self-reported an increase in understanding
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15 pre-determined taught competencies, six months after the program completion (Fennimore &
Wolf, 2011). Managers also indicated the topics as being the most valuable to their success
included finance, conflict management, emotional intelligence application, and strategies to
engage staff (Fennimore & Wolf, 2011). The results of this study also indicated a verbalization
from the few participants of improved behaviors and knowledge after attending the program.
Again, the results are self-reported and subjective in nature. A more objective evaluation is
needed to confirm nurse manager commentary.
In 2010, in another small qualitative study of structured interviews with nurse managers,
three themes emerged. These themes include role ambiguity, business management deficits, and
role overload (McCallin & Frankson, 2010). The analysis of the themes lead to three
conclusions. First, leadership training should be offered to staff nurses who possess potential
role advancement attributes. Second, organizations must provide financial resources to provide
in house training for specific nurse management. And last, there should be ongoing mentorship
in a supervisory manner (McCallin & Frankson, 2010). These arguments point to the need for
organizations to improve in house nurse manager orientation programs and begin leadership
training to staff nurses who show future promise. There needs to be further studies to compare in
house versus collaborative ventures for orientation programs.
Other literature supports the findings for organizations to provide internal orientation
programs for new nurse managers. It is essential to focus on the leadership competencies which
correlate leader outcomes that are effective (Macphee, et al, 2014). In this study leadership
development focused on impacting relationships within the workplace to positively impact
outcomes (Macphee, et al, 2014). The education consisted of a four day workshop and included
lecture and interactive strategies for novice leaders (Macphee, et al, 2014). The study identified
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knowledge gaps related to leadership outcomes and educational opportunities of empowering
behaviors to enhance them (Macphee, et al, 2014). The outcome of the study displayed that
empowering behaviors are teachable and are demonstrated one year after the four day workshop
(Macphee, et al, 2014). This study was limited by its small group of participants in the control
group. Duplicate studies with a substantial control group are needed to solidify results.
Earlier bodies of work appear to support an in house orientation program. In 2009,
Virginia Commonwealth University Health System in Richmond VA’s program concentrated on
elements of leadership, retention, clinical management, coaching, mentoring, human resources
management, fiscal management, performance improvement, and evidenced-based practice
through classroom teaching and competency checklists (Hawkins, Carter, & Nugent, 2009). In
this orientation program new nurse managers did not take responsibility of the department until
the orientation is complete in order to remain focused on the learning opportunities (Hawkins et
al., 2009). Anecdotally, the results reflected improvements in nurse manager satisfaction
reporting. There was no formal results from this program. However, there were lessons learned
to update the program, with no tangible results of its effect.
In reviewing the literature, there is consensus that any strategy to improve nurse manager
competencies must be innovative in nature. Again, collaborative efforts with academia is one
method to such innovation (Digman et al., 2012). Another innovative method is simulation.
Leadership development program participants can benefit from more engagement than didactic
sessions or computer based programs with simulations (Radovich et al., 2011). Since simulation
has been successful in other applications such as aviation, placing nurse leaders in lifelike
situations promotes behavioral aspects of understanding content (Radovich et al., 2011). One
pilot program aimed to develop and implement a leadership development program employing
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three video recorded simulation scenarios, post simulation debriefing, and re-participation of the
three simulations (Radovich et al., 2011). Participants reported to have a better understanding of
how their communication, both verbal and non-verbal are perceived (Radovich et al., 2011).
Participants also felt they had an improved ability to have crucial conversations in difficult
situations (Radovich et al., 2011).
Other literature reviews the benefits of coaching versus mentoring. Even if the novice
nurse manager is fortunate to attend a leadership development program, there is still a need for
ongoing guidance and in the moment learning. Peer preceptors are often assigned to look after a
new manager. However, assigned preceptors for novice leaders are often consumed with the
demands of the role and offer minimal time to the new manager (DeCamli, Kirby, & Baldwin,
2010). The author will utilize a mentor in the form of a formal preceptor for the duration of the
practicum project for guidance and support.
Theories for Nurse Manager Development
When developing a learning plan it is important to include models with proven success.
Patricia Benner’s model from Novice to Expert presents an appropriate theoretical framework for
educating nurse managers when dealing with experiential learning. According to Benner, the
nurse has the capability to attain meanings with direct involvement in a given circumstance
(Chinn & Kramer, 2008). For the learning practicum, this concept will be utilized by the
immersion process. The author will be in the role of the experienced bedside nurse and
considered a novice when transitioning to the new role of nurse leader, attempting to become
proficient with the four standards identified in the learning plan. It is this process that will
enable the ability to gain the experience to apply learned concepts through Benner’s five levels
of skill acquisition include novice, advanced beginner, competent, proficient, and expert
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(Abraham, 2011). Also attributed to Benner’s theory is that learning is secured through
repetition and over time (Abraham, 2011). The practicum will empower the author to experience
such repetition. Academic didactic teaching and best practice review alone is not optimal for
nursing administrator competency demonstration of skills and abilities. The literature points to
the importance of having opportunities for the novice nurse manager to practice strategies
reviewed in curriculums (Fennimore & Wolf, 2011). The learning practicum in a sense, provides
a leadership simulation opportunity in a real healthcare organization. According to Benner,
performing the task to demonstrate competence of defined criteria in the real world is essential
for measurement (Conley, Branowski, & Hanley, 2007). This type of practice within the
practicum can assist the learner with understanding the results of learned behavioral concepts.
According to Radovich et al, simulation of the complex issues related to the nurse manager role
can also provide an interactive method to acquire needed leadership skills including the various
aspects of effective communication (Radovich et al., 2011).
Transformational Leadership is an additional theoretical framework for the novice nurse
leader in this practicum. This framework for leadership is applicable to the learning practicum of
development of nursing leadership competencies, as it connects the drive of the follower to the
common intentions of the leader (Northouse, 2015). With transformational leadership there is a
sense of bonding with respect and trust between the leader and the team encouraging buy in
(Avolio & Yammarino, 2013). It is with this leadership style that will enable the author to assist
the team reach their fullest potential (Northouse, 2015) with the practicum project. When the
leader becomes engaged with the people, the parties involved become motivated (Northouse,
2015). This newly engaged team will ultimately help the longevity of the project after its
completion.
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Literature Limitations
In an attempt to determine its validity for the learning practicum, the literature findings
were examined to review any limitations. For this process it is important to look for sources
which conduct systematic research with randomization of participants to provide Level V and VI
evidence which is considered to be reliable (Fineout-Overholt, Melnyk, Stillwell, & Williamson,
2010). The literature available provided qualitative and descriptive evidence. One weakness in
the literature is that each of the studies were performed in single organizations with minimal
participants. Another weakness, is that the majority of the most recent literature weighs heavily
on academic institutions to bridge the gap of current curriculums in collaborating with various
healthcare organizations to provide joint orientation programs. What is requested for curriculum
content at one organization may not be important to another. A project between several
organizations could be studied to gain numbers in experienced educators including nurse
executives, human resources and academic educators. It is interesting that none of the literature
mentioned actual nursing educators for leadership development. This could be in part due to the
downsizing of education departments within healthcare organizations.
Evaluation is essential to understand the effects of program outcomes at its completion.
Many of the literature sources relied heavily on self-reporting of perceptions from the individual
novice nurse managers. None of the articles confirmed an increase in physically demonstrating
an improvement in nursing leadership competencies by means of a direct supervisor.
Application would be of benefit in evaluating a true understanding and utilization of the
competencies trained.
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Literature Review Conclusion
After reviewing the literature many things has been ascertained. Novice nurse managers
are often unprepared for leading in today’s healthcare system. Despite competency development
within the last decade from the ANA and the AONE, healthcare organizations lack structured
orientation programs specific to nurse managers. Earlier studies suggest providing in house
competency based orientation programs improves nurse manager knowledge and behaviors.
While more recent studies, point to collaborative efforts with outside entities such as Universities
to provide these types of programs. All literature points to innovation as being key to ensuring
novice nurse managers are prepared in today’s economic limitations. There are no evidence
based bodies of work which compares different types of orientation programs against one
another. Current studies have limited numbers of participants and provide subjective outcomes.
More research is needed to determine the most cost effective and comprehensive style of
program to provide to new nurse managers. Results from larger future studies should be
objective in nature. Healthcare stands to benefit when nurse managers are adequately prepared
for this challenging role.
Practicum Setting
The learning practicum will take place at (MMH)-Midland. This organization is a 240
bed, acute care, not for profit hospital that is headquarters of the (MMH) System in Lower
Michigan. MMH is also affiliated with the University of Michigan Health System, which
provides access to evidence based research outcomes, policy and procedure. Of note, the health
system has a strong nursing leader in the chief executive officer (CEO) position, Diane Postler
Slattery RN Ph.D. She is a strong proponent for advancing nursing practice with the financial
decision making incentive to do so. This is unique for a healthcare organization to have. The
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nursing department is governed by a chief nursing officer, four nursing directors, ten nurse
managers and numerous supervisors. The nurse managers will be the focus of the project, but
will open up the project to nursing supervisors as well. This site was chosen because the author
had previous experience within the leadership team and a good understanding of the different
departments in which the practicum will evolve.
Preceptor Selection
For the selection of a preceptor for the learning practicum, a meeting was scheduled with
the Vice President and Chief Nursing Officer. Jan Penney, RN, MSN is a veteran nurse with a
long career in leadership and an excellent role model. She has vast experience as a leader as she
has been in the role of nurse manager, director and her current role. She has been in her current
role for 3 years and is the driving force of progressing the role of nursing at MMH for over 10
years. Mrs. Penney has been instrumental with improving quality and safety within the
organization during this time. She is currently advocating for MMH to adopt a nursing
philosophy and improving the organization’s culture of safety. It was decided that, despite her
elevated level within the organization, she be the preceptor for the proposed practicum.
Mrs. Penney will be the student’s direct liaison for each step of the practicum plan.
Because she is the VP of nursing, she will be instrumental with knowing the venues that will be
beneficial for the author to be a part of. She leads a monthly nursing managers and directors
meeting, which includes ancillary department leaders. These leaders will all be essential for the
student to be in contact with in various forms throughout the practicum.
This preceptor has demonstrated many attributes of a good preceptor. This includes
being a great communicator, very knowledgeable in the identified areas for the practicum, and is
motivated in seeing the success of the venture with the student (The Effective Preceptor). She
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has accepted the responsibility of being an active observer over the practicum, and has a good
assessment of the student’s skills and abilities as a nursing leader. To view the preceptor/agency
agreement please see appendix B.
Evaluation Process
The evaluation process for lifelong learning is essential to determine if one has achieved
the goals and learning objectives set forth. This is true for the learning practicum as well. It is
important to ensure that the evaluator is able to objectively evaluate one individual against
another in a fair and consistent manner. When the evaluation process is based on measurable
learning outcomes, the learner is able to determine the steps necessary to achieve them.
Bloom’s Taxonomy is one such method in determining educational objectives. It is
important for the learner to move through the six categories of cognitive skills which include;
knowledge, comprehension, application, analysis, synthesis, and evaluation ("A model of
learning objectives," 2015). This approach can be closely linked to Patricia Benner’s model of
learning from novice to expert (Abraham, 2011), as one must acquire the knowledge as a novice
then move through the stages of application, analysis, and synthesis before becoming an expert.
Closely related to Blooms Taxonomy and Benner’s Learning Theory, is the Office of
Human Resources at the National Institutes of Health’s evaluation descriptors. These five
descriptors include fundamental awareness, novice, intermediate, advanced and expert
(2009). These descriptors were utilized in the development of the evaluation tool for the learning
practicum. To view the learning practicum evaluation please see appendix C.
Conclusion
Transitioning into a nurse administrator position can be a challenge. Simulating real life
learning opportunities via a structured learning practicum can help novice managers overcome
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these challenges. With the guidance of a preceptor, the author will utilize evidence based
practice strategies to initiate a nurse manager orientation project to assist with improving skills
and abilities. The learning practicum will take place at MMH from September through
December of 2015, and focus on activities to achieve outcomes for four ANA Scope & Standards
of Nursing Administration including; planning, implementing, educating and professional
practice evaluation. This will be evaluated using Bloom’s taxonomy at the mid-point of the
practicum, as well as at the conclusion.
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Appendix A
Clinical Practicum II Learning Plan Template- M Wendt
ANA Standards
of Practice:
Specialty role
ADMINISTRATI
ON
Standard #4
Planning
The nurse
administrator
develops a plan
that prescribes
strategies and
alternatives to
attain expected
outcomes.
(American Nurses
Association
[ANA], 2009, p.
28)
Outcome Criteria: Activities to
(taken from the
Achieve Outcome.
ANA
Standards/NLN
Competencies)
1.
1. Participates
A. Develop
in the design
evidence
and
based
development
orientation
of
plan/policy/
multidisciplin
process for
ary and
nurse
interdisciplin
manager
ary processes
group using
to address the
an
situation or
interdisciplin
issue.
(American Nurses
Association [ANA],
2009, p. 28)
Resources needed
to be successful
Timeline
1A.
Sept-Dec
2015
a) Literature on
best practice for
nurse manager
orientation
processes.
b) AONE Nurse
executive
competencies.
c) ANA
Administration
Scope and
Standards
ary approach
at
MidMichigan
Health
(MMH).
d) Nursing and
non-nursing
theory for
learning &
change. (Most
likely Benner/
Novice to
Expert, Studor,
Lewin?)
e) Nursing
philosophy
(Newly
developed
Summer 2015)
B. Analyze
current policy
on nurse
manager
orientation
related to
1B.
a) Current
orientation
policy and
tool/checklist
NURSING PRACTICUM PAPER
23
non-nursing
departments
C. Revise key
educational
topics/checkli
st needed for
nurse
manager
success.
1C.
a. List of ancillary
non-nursing
department’s
liason.
b. Current
orientation
tool/checklist.
D. Perform Root 1D.
Cause
a. Meeting with
analysis or
current nurse
FEMA for
managers,
current/rece
directors,
nt orientation
education
deficiencies.
department
manager, HR
representation,
and VP of
nursing for
topics to be
included in new
process/
identify
weaknesses in
current process.
E. Determine
common
stressors of
newly hired
nurse
managers.
1E.
a. Meeting with
current nurse
managers to
discuss
experiences
b. Literature on
stressors of the
new nurse
manager
2. Considers the 2.
A. Develop cost
economic
analysis of
impact of the
proposed plan.
plan.
(Included: the
cost of nurse
2A.
a. Meeting with
human
resource.
NURSING PRACTICUM PAPER
24
manager
turnover).
(American Nurses
Association [ANA],
2009, p. 28)
b. EBP literature
for cost of nurse
manager
turnover and
time devoted to
orientation
process.
2B
a. Meeting with
Nursing
Directors & VP
of nursing
B. Determine time
allotment for
orientation.
2C.
C. Determine
budget
availability for
outside
programs.
a. Meeting with
Nursing
Directors & VP
of nursing
2D.
a. Meeting with
finance
department to
determine
cost/benefit
ratios.
D. Calculate cost
benefit ratio of
orientation/
nurse manager
turnover.
Standard #5
Implementation
The nurse
administrator
implements the
identified plan.
(American Nurses
Association
[ANA], 2009, p.
29)
1. Facilitates
utilization of
systems and
community
resources to
implement
the plan
(American Nurses
Association [ANA],
2009, p. 29)
1.
1A.
A. Organize
meetings with in
house
departments
(Physician
stakeholder
included), as well
as possible
community
entities to
determine
available
resources.
a. Contact person
for various
departments
and
organizations.
Sept-Dec
2015
NURSING PRACTICUM PAPER
25
2A.
2. Collaboration 2.
A. Determine
a. Meeting with
with nursing
responsibilities
stakeholders
colleagues
for process
(Including
and others to
completion
at
the
human
implement
end
of
6
months
resources)
the plan.
after hire.
(American Nurses
Association [ANA],
2009, p. 29)
b. Contact person
for various
stakeholders.
c. Calendars for
various
stakeholders
Standard # 8
Education
The nurse
administrator
attains knowledge
and competency
that reflects
current practice.
(American
Nurses
Association
[ANA], 2009, p.
36)
1. Seeks
experiences
and
independent
learning
activities that
reflect
current
practice in
order to
develop,
maintain and
improve
skills and
competencies
in nursing
administratio
n role.
(American Nurses
Association [ANA],
2009, p. 36)
2. Maintains
professional
records that
provide
evidence of
competency
and lifelong
learning.
1.
1A.
A. List learning
opportunities for
nurse manager
education.
a. Collaborate with
local universities
and colleges.
b. List of yearly
state
conference
offerings for
nurse manager
conferences
B. Determine
current offerings
for nurse
manager
orientation at
MidMichigan
Health
2.
1B.
a. Meeting with
education
department
2A.
A. Construct
competency tool
utilized for nurse
manager
orientation to
maintain in
human resources
file.
a. Tools utilized to
document
competency
from other
organizations.
Sept-Dec
2015
NURSING PRACTICUM PAPER
26
B. Utilize hospital
technology to
obtain data
regarding nurse
manager
competencies
(American Nurses
Association [ANA],
2009, p. 36)
Standard # 9
Professional
Practice
Evaluation
The nurse
administrator
evaluates own
nursing practice in
relation to
professional
practice standards
and guidelines,
relevant statutes,
rules, and
regulations.
1. Interacts with
peers and
colleagues to
enhance own
professional
nursing
practice and
role
performance.
1.
2B.
a. IT liaison
b. Human resource
data
1A.
A. Determine what
is needed to
enhance nurse
manager
professional
practice as
leaders.
(American Nurses
Association [ANA],
2009, p. 37)
B. Create and
communicate
project outcomes
in a nonthreatening
manner
(American Nurses
Association
[ANA], 2009, p.
37)
a. AONE Nurse
executive
competencies.
b. Meeting with
Nurse
managers/Direc
tors
2B. Transformational
Leadership guidelines
and literature
2A.
2. Takes actions
to achieve
goals
identified
during the
evaluation
process.
(American Nurses
Association [ANA],
2009, p. 37)
2.
A. Develop
evaluation
process for the
completion of the
nurse leader
orientation
process.
B. Measure and
analyze
performance
from learning
a. Local healthcare
organization’s
evaluation
processes.
b. Evidence based
practice
evaluation
methods.
2B. Benchmarking of
nursing data for
turnover rates &
magnet designation
status
Sept-Dec
2015
NURSING PRACTICUM PAPER
27
Appendix B
Student-Preceptor-Agency- Agreement
The overall objective of this experience is to provide an on-site setting in which a student, with
the preceptor (professional employee of a health care agency), can further develop his/her
understanding and skills related to an advanced nursing role specialty.
Agency name ____MidMichigan Health-Midland
Student name ___Marie Wendt_______
Student Telephone # ___989-529-1957
Preceptor name __Jan Penney RN, MSN__
Preceptor’s Title:__ Vice President and Chief Nursing Officer
Preceptor Telephone #____ 989-839-3645
Email_ jan.penney@midmichigan.org
Agency representative ___Colleen Markel___
Agency representative Title _ Manager of Workforce Development
Agency representative Telephone #__989-839-3120
Email___colleen.Markel@midmichigan.org
The following learning outcomes and activities will be completed by the student during this
project/practicum.
A. Develop evidence based orientation plan/policy/ process for nurse manager group using an
interdisciplinary approach at MidMichigan Health (MMH).
B. Analyze current policy on nurse manager orientation related to non-nursing departments
C. Revise key educational topics/checklist needed for nurse manager success
D. Perform Root Cause analysis or FEMA for current/recent orientation deficiencies.
E. Develop cost analysis of proposed plan. (Included: the cost of nurse manager turnover).
F. Determine budget availability for outside programs.
G. Organize meetings with in house departments (Physician stakeholder included), as well as
possible community entities to determine available resources.
H. Construct competency tool utilized for nurse manager orientation to maintain in human
resources file.
I. Utilize hospital technology to obtain data regarding nurse manager competencies
J. Develop evaluation process for the completion of the nurse leader orientation process.
SIGNATURE SIGNIFYING AGREEMENT TO THE TERMS OF THIS PRECEPTOR
AGREEMENT:
Student _________________________________________
Date ___________________
Preceptor(s) _______________________________________ Date ___________________
Agency representative _______________________________ Date ___________________
NURSING PRACTICUM PAPER
Appendix C
***CHOOSE ONE***→
28
Learning Practicum Evaluation Tool
Marie Wendt RN, BSN
Ferris State University
Midterm Evaluation _______ October 12, 20115 OR Final Evaluation ______ November 30, 2015
Evaluation Key:
Score
Proficiency Level
N/A
Not Applicable
1
Fundamental
Awareness
(basic knowledge)
Description
You are not required to apply or demonstrate this competency. This competency is not applicable to your
position.
You have a common knowledge or an understanding of basic techniques and concepts.

Focus is on learning.
You have the level of experience gained in a classroom and/or experimental scenarios or as a trainee on-thejob. You are expected to need help when performing this skill.
2
Novice
(limited experience)



Focus is on developing through on-the-job experience;
You understand and can discuss terminology, concepts, principles, and issues related to this
competency;
You utilize the full range of reference and resource materials in this competency.
You are able to successfully complete tasks in this competency as requested. Help from an expert may be
required from time to time, but you can usually perform the skill independently.
3
Intermediate
(practical
application)

Focus is on applying and enhancing knowledge or skill;

You have applied this competency to situations occasionally while needing minimal guidance to
perform successfully;
NURSING PRACTICUM PAPER
29

You understand and can discuss the application and implications of changes to processes, policies,
and procedures in this area.
You can perform the actions associated with this skill without assistance. You are certainly recognized
within your immediate organization as "a person to ask" when difficult questions arise regarding this skill.
4
Advanced
(applied theory)





Focus is on broad organizational/professional issues;
You have consistently provided practical/relevant ideas and perspectives on process or practice
improvements which may easily be implemented;
You are capable of coaching others in the application of this competency by translating complex
nuances relating to this competency into easy to understand terms;
You participate in senior level discussions regarding this competency;
You assist in the development of reference and resource materials in this competency.
You are known as an expert in this area. You can provide guidance, troubleshoot and answer questions
related to this area of expertise and the field where the skill is used.


5
Expert
(recognized
authority)



Focus is strategic;
You have demonstrated consistent excellence in applying this competency across multiple projects
and/or organizations;
You are considered the “go to” person in this area within NIH and/or outside organizations;
You create new applications for and/or lead the development of reference and resource materials for
this competency;
You are able to diagram or explain the relevant process elements and issues in relation to
organizational issues and trends in sufficient detail during discussions and presentations, to foster a
greater understanding among internal and external colleagues and constituents.
(Office of Human Resources at the National Institutes of Health, 2009, table 1)
NURSING PRACTICUM PAPER
30
***Please place a check mark in the appropriate box.
Standard #4
Planning
The nurse administrator develops a plan that prescribes strategies
and alternatives to attain expected outcomes.
(American Nurses Association [ANA], 2009, p. 28)
Participates in the design and development of multidisciplinary and interdisciplinary process to address the situation or issue
(American Nurses Association [ANA], 2009, p. 28)
Not
Applicable
Utilizes evidence based literature in
development of orientation project
process
Actively demonstrates utilization of
theory during project process
Incorporates newly developed MMH
nursing philosophy in planning of
process of the nurse manager orientation
process.
Develops newly structured nurse
manager orientation policy.
Collaborates well with current nurse
manager team well to develop new
policy, protocol, and checklist.
Collaborates well with current ancillary
departments personnel including human
resources and educational services.
Conducts an effective RCA/FMEA with
appropriate stakeholders and utilizes
Fundamental
Awareness
Novice
Intermediate
Advanced
Expert
NURSING PRACTICUM PAPER
31
findings to determine gaps in current
process.
Considers the economic impact of the plan
(American Nurses Association [ANA], 2009, p. 28)
Not
Applicable
Fundamental
Awareness
Novice
Intermediate
Advanced
Expert
Effectively collaborates with finance
department in developing cost effective
plan.
Effectively collaborates with senior
leadership (Nursing Directors and VP,
Education, Human Resources) in
understanding financial impact of
orientation plan.
Applies best practice evidence of financial
limitations related to effective nurse
manager orientation
Standard #5
Implementation
The nurse administrator implements the identified plan.
(American Nurses Association [ANA], 2009, p. 29)
Facilitates utilization of systems and community resources to implement the plan (American Nurses Association [ANA], 2009, p. 29)
Not
Fundamental
Novice
Intermediate
Advanced
Expert
Applicable
Awareness
Facilitates meetings with ancillary
departments, physician stakeholders and
community entities to determine available
resources.
NURSING PRACTICUM PAPER
32
Arranges consultation with state academic
and healthcare institutions to compare
leadership education strategies
Collaboration with nursing colleagues and others to implement the plan. (American Nurses Association [ANA], 2009, p. 29)
Not
Fundamental
Novice
Intermediate
Advanced
Applicable
Awareness
Collaborates with leaders to determine
appropriate and available resources to
teach various aspects of the plan.
Expert
Collaborates with individual ancillary
departments to design the
implementation strategy.
Standard # 8
Education
The nurse administrator attains knowledge and competency that reflects current practice.
(American Nurses Association [ANA], 2009, p. 36)
Seeks experiences and learning activities that reflect current practice in order to develop, maintain, and improve skills and
competencies in nursing administration role. (American Nurses Association [ANA], 2009, p. 36)
Not
Fundamental
Novice
Intermediate
Advanced
Expert
Applicable
Awareness
Able to list current offerings for nurse
manager orientation.
NURSING PRACTICUM PAPER
33
Able to list learning opportunities for
furthering nurse manager orientation
competency understanding.
Collaborates with local academic
institutions to address gaps in leadership
preparation
Maintains professional records that provide evidence of competency and lifelong learning.
(American Nurses Association [ANA], 2009, p. 36)
Not
Applicable
Fundamental
Awareness
Novice
Intermediate
Advanced
Expert
Constructs competency tool to be utilized
for nurse manager orientation to be
maintained in human resources file.
Develops new nurse manager evidenced
based reference binder.
Standard # 9
Professional Practice
Evaluation
The nurse administrator evaluates own nursing practice in relation to professional practice standards and guidelines, relevant
statutes, rules, and regulations.
(American Nurses Association [ANA], 2009, p. 37)
Interacts with peers and colleagues to enhance own professional nursing practice and role performance.
(American Nurses Association [ANA], 2009, p. 37)
Not
Applicable
Fundamental
Awareness
Novice
Intermediate
Advanced
Expert
NURSING PRACTICUM PAPER
34
Analyzes gaps in current nurse manager
professional practice at MMH
Assembles social support system into the
nurse manager orientation process
Takes actions to achieve goals identified during the evaluation process. (American Nurses Association [ANA], 2009, p. 37)
Not
Fundamental
Novice Intermediate
Advanced
Applicable
Awareness
Constructs process for evaluating new
orientation process/policy using EBP
Develops process for team evaluation of
orientation project outcome
EVALUATOR’S general comments:
STUDENTS Comments:
Expert
NURSING PRACTICUM PAPER
35
Student Name________________________ Student Signature________________________________ Date: ________________
Evaluator’s Name_______________________ Evaluators Signature _____________________________ Date: ________________
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