Interview of a Nurse Leader
Interview of a Nurse Leader
Leadership is a process through which a person influences others to achieve different common goals (Grossman & Valiga, 2017). The leader is the director and inspiration for action and should possess the combination of skills and personality that the followers want to emulate or be associated with. Nursing is a dynamic and challenging profession requiring engaging and inspiring role models and leaders (Scully, 2015). Not all nurses begin their career with thoughts of becoming a leader. Yet, strong leadership will be required to transform the healthcare system. In today’s ever changing and demanding healthcare environment, identifying and developing nurse leaders is one of the greatest challenges faced by the nursing profession (Scully, 2015). This stems from “lack of education and preparation necessary to adapt to new roles quickly in response to rapidly changing healthcare settings and an evolving healthcare system. Restrictions on scope of practice and professional tensions have undermined the nursing profession’s ability to provide and improve both general and advanced care” (Institute of Medicine ; Robert Wood Johnson Foundation, 2011, p. 25-26). Leadership from nurses is needed at every level and across all settings. Strong leadership is critical if the vision of a transformed healthcare system is to be realized. Hence, a transformed system will require nurses with the adaptive capacity to take on reconceptualized roles in new settings, educating and reeducating themselves along the way, and indispensable characteristics of effective leadership (IOM ; RWJF, 2011).
The purpose of this paper is to analyze the interview that was conducted with Dr. Laure Marino, an outstanding nurse leader in Charleston, West Virginia. The interviewee’s career, description of leadership, leadership behaviors and characteristics, leadership style, organizational position and relevance to this author’s professional development will be discussed in detail utilizing the leadership guide. A conclusion on the effectiveness of the interviewee’s leadership in light of the analysis provided will also be discussed.
Interviewee’s Personal, Educational Background, Career, Organizational Position and Achievements
Dr. Laure Marino is a “59-year-old female native of Des Moines, Iowa. She moved to Charleston, WV, in 1995. Dr. Marino obtained her bachelor’s in science of nursing (BSN) from Creighton University in 1981. In 1985, she obtained a master’s degree in community and public health from University of Memphis. In 1997, she obtained her master’s in science of nursing (MSN) in family and gerontology nurse practitioner from West Virginia University (WVU). In 2016, she obtained a doctorate degree in nursing practice (DNP), executive leadership from George Washington University” (L. Marino, DNP, personal communication, October 10, 2018).
Dr. Marino is a board-certified family and geriatric nurse practitioner. She has maintained practice in Charleston, WV since 1997. Dr. Marino has provided care to patients in the community in both FNP and DNP positions overtime. Dr. Marino is currently a care provider and the director of outpatient primary care services in Process Strategies Highland Behavioral Health Services, an outpatient clinical arm of Highland Hospital (Nuzum, 2015). Dr. Marino believed that healthcare is about “more than providing quality care but about paying attention to the details that affect patients and their lives; often, that starts with access to care” (Rust, 2017, para. 2). Lack of access to care is a health disparity. Healthy People 2020 (as cited in HealthyPeople.gov, 2014), defined health disparity as a health difference that is closely linked with social, economic, and/or environmental disadvantage. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health (HealthyPeople.gov, 2014). Dr. Marino was knowledgeable that some of her patients did not have access to receive care or services because of transportation issues. She said “many of her patients came by bus, but Highland wasn’t on a bus route. Dr. Marino met with officials at the Kanawha Valley Regional Transportation Authority KRT. After months of meetings and cajoling, KRT did a major reroute and added a stop close to Highland hospital” (Rust, 2017, para. 6). Dr. Marino has been “active in working to combat one of the state’s biggest problems: smoking. In her practice alone, nearly a third of her patients smoked. Dr. Marino put in place resources provided by WV state programs to help smokers in quitting smoking. She focused on discussing smoking with her patients. So far, nearly half of the smokers in her practice have quit smoking” (Rust, 2017, para. 9-11).
In 2015, Dr. Marino was “one of ten nurses that was nationally awarded the Culture of Health Breakthrough Leaders in Nursing award. Presented by the Robert Wood Johnson Foundation RWJF and AARP American Association of Retired Persons, the prestigious award recognizes nurses who are working to create healthy communities” (Rust, 2017, para. 5). The award celebrates nurse leaders and position nurses for leadership and executive roles to help people live healthier lives and create healthier communities. Dr. Marino was recognized in the award for “opening the first nurse-led, reverse-integrated i.e. primary care services are placed in a behavioral health setting care practice in WV” (L. Marino, DNP, personal communication, October 10, 2018). As the only primary care provider at Process Strategies, Dr. Marino works to treat the physical diseases that many of Highland’s behavioral health patients suffer from (Nuzum, 2015). Dr. Marino’s practice is “not just limited to behavioral health patients but also to new patients with or without needs for behavioral healthcare” (L. Marino, DNP, personal communication, October 10, 2018).
Dr. Marino is an assistant professor of nursing at WVU school of nursing (Gold, 2018). Dr. Marino is “helping to shape the future of healthcare in WV as an active member of the West Virginia Action Coalition. With the state’s action coalition, Dr. Marino and others work to recruit new nurses and keep existing ones. Dr. Marino is also speaking out as an ambassador and consulting as part of the Future of Nursing: Campaign for Action” (Rust, 2017, para. 12-15). As co-chair of the Future of Nursing WV Leadership Team, she developed a data base of available board positions for nurses and is helping to design and write the online training curriculum that will prepare rising nurse leaders for those board positions (Future of Nursing West Virginia, n.d.). “Since receiving the Culture of Health Breakthrough Leaders in Nursing award, Dr. Marino has traveled to Washington, DC to meet the other national winners and attended a week-long leadership development program” (Rust, 2017, para. 13). Dr. Marino is affiliated with many hospitals including Charleston Area Medical Center and cooperates with other doctors, specialists and physicians in medical groups including Highland Behavioral Health Services Inc.
Relevance to Personal Professional Development
This author chose to interview Dr. Marino because of her numerous works/achievements in the nursing profession and the services that she has provided in the community especially on patients with psychiatric and mental health issues. Mental health care is one of the biggest unmet needs of our time. Millions of people living with these conditions do not receive the care that they require, which is appalling. Without access to affordable treatment, many have a hard time holding down a job, yet do not qualify as formally disabled; thus, leaving them locked out from insurance coverage. This is a very serious issue in our society that needs to be eradicated.
This author is aspiring to be a psychiatric mental health nurse practitioner and a leader in the future. In this position (psychiatric mental health nurse practitioner), this author intends to make a difference in the lives of people with mental health needs, be a great patient advocate and attain nursing leadership positions that will help shape the future of nursing and healthcare. The interview conducted with Dr. Marino highlighted exceptional and indispensable care practice and leadership skills that she possesses. This interview has also helped this author to have greater insight on what it takes to be a great care provider, leader and achieve success. Hence, this author aims at emulating these skills that Dr. Marino possesses as they will be vital in this author’s personal and professional development.
Description of a Leader
Leadership is a process through which a person influences others to achieve different common goals (Grossman & Valiga, 2017). When asked to describe a leader, Dr. Marino described a leader as:
One who inspires confidence and support among the people who are needed to achieve organizational goals. Additionally, she described a leader as one who wants to do the right thing and passionate about his/her job and services to the people. The goal of a leader is to inspire and elevate the staff to a different level and guide them towards a shared organizational vision. A leader has confidence in his/her ability to solve problems and the capacity to motivate people. (L. Marino, DNP, personal communication, October 10, 2018).
Leaders are the backbone of any organization; they have the task of providing directions and insights to followers to comply with the organizations mission and meet organizational goals. Leaders use their power to spark innovations, bring teams together, create positive communications, and drive forward towards the goals of the organization (Grossman & Valiga, 2017).
Leader behaviors are the actions or behaviors that define a leader (Porath, 2015). The behaviors of leaders affect their followers and the accomplishment of their organizational goals. When asked about behaviors that a leader should exhibit, Dr. Marino stated that leaders “should have high moral standards, confidence, integrity, credibility, values, vision, accountability and emotional competence” (L. Marino, DNP, personal communication, October 10, 2018). Dr. Marino possesses these aforementioned leader behaviors as evidenced by her works/achievements as a care provider and leader (Rust, 2017; Gold, 2018; Nuzum, 2015; Future of Nursing West Virginia, n.d.). Organizational success results from strong leadership. Leadership attributes such as integrity, credibility, accountability, vision, power, motivation, stewardship, value, change and positive communication, result in the realization of organizational goals and objectives (Grossman & Valiga, 2017).
Leadership style is defined as the relatively consistent pattern of behavior that characterizes a leader (Grossman &Valiga, 2017). Leadership style is a leader’s way/manner of providing directions, executing plans, and encouraging people. Dr. Marino described her leadership style as “transformational” (L. Marino, DNP, personal communication, October 10, 2018). Transformational leaders are individuals who increase the followers’ awareness of what needs to be done to achieve the shared goal. Per Grossman & Valiga (2017), transformational leaders:
Emphasize the importance of following a vision and assisting others to participate in making it a reality. They communicate their values and beliefs to others so that they can achieve a common meaning in their work and realize the vision toward which all are striving for. They trust others, are honest, and act responsibly; they use their talents and expertise to express their desire for and commitment to a vision. (p. 111).
Dr. Marino had an innovative vision, she shared her vision to her followers and the organization in its entirety, she emphasized on the importance of following the vision, and motivated her followers to participate in making her vision a reality. Dr. Marino’s transformational leadership style resulted in the aforementioned achievements in her career.
Being able to recognize issues, feelings of colleagues, motivate others and manage one’s own emotions well in relationships serves to foster an environment that facilitates transformational leadership (Grossman & Valiga, 2017). Dr. Marino recognized issues with the care delivery system in her organization (patient access to care, smoking and poor management of medical ailments of the mentally ill) that were affecting patient outcomes. She had an innovative vision on how this problem should be solved thereby improving patient outcomes. Nurses can be particularly savvy with interdisciplinary collaboration because they are the professionals who spend the most time with patients and presumably would have the opportunity to obtain the most knowledge about the patient (Grossman & Valiga, 2017). This experience (nursing) and knowledge helped Dr. Marino in developing a successful plan that resulted in positive patient outcomes.
Dr. Marino has also used her leadership position as the co-chair of the Future of Nursing WV Leadership Team to develop a data base of available board positions for nurses and has helped to design and write the online training curriculum that will prepare rising nurse leaders for those board positions. One of her “goals as a leader is to transform healthcare by creating positions that will help groom/prepare nurses for leadership positions” (L. Marino, DNP, personal communication, October 10, 2018). By doing so, nurses will impact and influence change in the healthcare system. Per Gold (2018), Dr. Marino was asked about the most important action that nurses can take to lead the way to improve health and healthcare in America? Dr. Marino stated:
Do something, find your voice, influence policy, speak up and out, be a patient advocate and be a profession advocate. Don’t wait around for someone else to protect your scope of practice or your patient’s access to care. Learn to take your brilliant ideas for better health from idea to action. Sign up for a committee, contact a legislator, write an op-ed. Recognize the power that nursing holds to influence and impact change. (para. 8).
The nursing profession must produce leaders throughout the healthcare system from the bedside to the boardroom, who can serve as full partners with other health professionals and be accountable for their own contributions to delivering high-quality care while working collaboratively with leaders from other health professions (IOM & RWJF, 2011).
Leadership Characteristics/Skills Critical for Effective Leadership
Leadership characteristics/skills are essential for effective leadership. Per Grossman & Valiga (2017), a good leader should have fundamental elements such as vision, communication skills, change, stewardship, developing and renewing followers. To these elements, Dr. Marino added “honesty, integrity, inspiration, emotional competence, humility, assertiveness, creativity, flexibility, innovation and confidence” (L. Marino, DNP, personal communication, October 10, 2018). By creating a vision, strategizing how to accomplish the vision, seeking creative ways to implement change and effectively leading or following in a collaborative manner, nurses exercise the leadership skills that will assist the entire health team in accomplishing its goals whether they are quality patient care, educational excellence or building the science of nursing (Grossman & Valiga, 2017).
Conclusion on the Effectiveness of the Nursing Leader
Nursing is a dynamic and challenging profession requiring engaging and inspiring role models and leaders (Scully, 2015). A good nurse leader is someone who can inspire others to work together in pursuit of a common goal such as enhanced patient care. An effective leader has a distinctive set of personal qualities such as integrity, courage, initiative and an ability to handle stress. This individual is often admired in their efforts to think critically, set goals and skillfully communicate and collaborate. A leader should possess a combination of skills, characteristics and qualities that aids in accomplishment of organizational goals and effective leadership. Leaders must also be equipped with leadership styles and characteristics that enables them to effectively manage operations at their respective organizations.
Dr. Marino is a great asset to her patients, community and the nursing profession in its entirety. She has demonstrated combination of skills, characteristics/qualities in both leadership and care provider positions. Dr. Marino is an exceptional nurse leader, phenomenal care provider and patient advocate, and a role model in the nursing profession. Her role as a care provider in the community resulted in numerous positive patient outcomes that got recognition from the RWJF and AARP. This recognition earned her an award (The Culture of Health Breakthrough Leaders in Nursing); making her one of ten nurses nationally that received this award. Her role as a leader has resulted in accomplishment of organizational goals, great patient outcomes and numerous accomplishments in her career that have been discussed in this paper. Additionally, her role as a leader and educator in nursing is continually preparing and paving the way for rising/future nursing leaders that will aid in transformation of the nursing profession and healthcare. Hence, it is essential to the future success of the nursing profession that informal negative leaders be discouraged and positive leaders possessing the evidence-based qualities of leadership be identified and nurtured to lead the profession (Scully, 2015).