international honour society of nurs-
international honour society of nurs-
WHAT SKILLS WILL THE
Keynote speaker at the conference, American nursing professor and former president of the international honour society of nurs-
ing, Sigma Theta Tau, Carol Huston, painted a picture of a brave new nursing world in 2020, in her opening presentation, Preparing nurse leaders for 2020.
She outlined eight leadership competencies every nurse leader would need in the 2020. The rst was a global perspective. “Every health care issue has to be looked at from a global perspec- tive. We used to think pandemics were con ned to developing countries. We now know they are just one short ight away.”
There was a more urgent need for interna- tional standards for basic nursing education. The nursing shortage was one of the most serious threats to global health, she said, and it would get signi cantly worse before it got better. Nurse migration was a global problem. (See news p7.)
The second leadership competency was better use of technology to connect people. Technology had driven so many changes already in health care but knowledge and information acquisition and distribution was going to multiply exponen- tially. “Forty percent of what we know today will be obsolete in three years,” Huston said.
She listed a range of technological develop- ments that would have a major impact on health care in the next 20 years. By 2030 diagnostic body scans, which could identify underlying pathology, would become part of showering. Improvements in body scanning technology would mean there would be no need for invasive surgery or tests. “Nano bots” circulating in the blood stream would identify disease processes and begin to repair them. Gene therapy would mean what was now untreatable would be treat- able and could see cancer abolished completely
within two decades. Stem cell therapy would eliminate the need for organ transplants “as we will grow new organs. It is predicted we will be able to grow heart, kidneys and livers by 2020. There are already clinical trials underway grow- ing new teeth – instead of dentures you would grow you own new teeth.”
Merging of the human and the machine would advance signi cantly and by 2020 there would be pancreatic pacemakers for diabetics and the technology to enable blind people to see and deaf people to hear.
Robotics would continue to develop, with physical service robots which could wash pa- tients and help feed and carry patients. There was the potential for the use of robots in therapeutic roles. Paro, a robotic seal developed in Japan, responded to patting by closing its eyes and moving its ippers and was already being used as a therapeutic device for those with autism and Alzheimers. Kansei (emotion) robots are being developed and are programmed so key words trigger facial expressions.
Robotic simulation for nursing education provided a safer environment for students and mannequins could now cry, sweat, and become cyanotic. “The challenge for nurse leaders in 2020 will be how much simulation is too much? How important is human contact to learning the art of professional nursing?” Huston said.
Other areas of development would be digital records of health care history, the continued development of biometrics, with con dentiality protected by biometric signatures, the increas- ing use of “smart” objects, including a bed that could call a nurse if the patient was attempting to get out of bed, or a coverlet which could take a patient’s vital signs as they lay in the bed.
“Nursing leaders will have to balance tech- nology and the human element. I’m not worried about the science of nursing but I am a little worried about the art of nursing. Technology can supplement but not replace nursing care,” Huston said.
The third leadership competency was expert decision-making skills rooted in both empirical science and intuition. She referred to “wicked” problems, ie those with no right answers. Clinical decision support software packages will, with provider input of data, come up with a list of differential diagnoses and best practice.
There would be increasing numbers of tools to help decision makers, including the opportu- nity to buy information and advice from expert networks of thinkers. Nurse leaders with both
right brain and left brain skills were needed and Huston suggested that nurse leaders should sur- round themselves with people with a different brain dominance from their own.
The fourth leadership competency was the development of organisational cultures which emphasised quality patient care and worker and patient safety. “There has been an inordinate amount of money spent on medical errors but we haven’t seen that greater reduction in error rates. Part of the reason is how health care systems are created.”
If as much energy was focused on xing the underlying processes which caused errors as was focused on blame, much more would be learnt. “I’m not absolving individual health providers. We must nd a balance between creating safer health care systems and individuals’ responsibil- ity for the care they provide.”
Being politically smart was the fth leader- ship competency. “Nurses are the largest group of health care professionals but they are not always an integral part of health care decision making. This has something to do with how women are socialised to view power and with how they have been controlled by outside forces, notably medical and administrative. Politics can be de ned as the art of using power effectively. In 2020 nursing input will be needed more than ever. Nurses must use their political skills to solve problems such as workforce shortages, turnover rates, reforming broken health care sys- tems and bringing nursing education entry levels up to that of other professions,” Huston said.
Team building skills
Nurse leaders of 2020 must also have highly developed collaboration and team building skills. The key to leadership success in 2020 would be the ability to integrate the priorities of industrial age leadership, with its emphasis on productivity, and relationship age leadership. “Health in 2020 will be characterised by highly educated, multidisciplinary experts and this will complicate, not ease teamwork. The key will be to create teams of experts, not expert teams. The nurse leader will have to be a team builder.”
The nurse leader of 2020 must be visionary and proactive in response to an environment which will be increasingly characterised by chaos and change. “Health care organisations in the 21st century will be in a state of con- stant, dramatic change and will be more uid, more exible and more mobile. Nurse leaders in 2020 will be experts in addressing resistance
Carol Huston – a brave new nursing world
14 KAI TIAKI NURSING NEW ZEALAND > JULY 2010 > VOL 16 NO 6
conference coverage
NURSE LEADERS OF 2020 NEED?
to change and helping followers work through that change.”
The nal leadership competency was ensuring leadership succession, given the average age of a nurse in the United States is 47. “We must do a better job of mentoring the newest members of our profession.”
She explained the “Queen Bee Syndrome”, a characteristic of female occupations – “the nurse leader who has had to struggle to get to the top and is so embittered by the struggle she thinks every nurse should have to go through that to get to the top.”
Huston said mentoring and nurturing was
the key to advancement in traditionally male occupations.
She referred to “demographic invisibles”, ie those people not even considered for leader- ship roles because of their ethnicity, gender, age or nationality, and “stylistic invisibles”, ie those who didn’t t the stereotype of a leader. “Nursing education programmes must be much more open about where the next generation of leaders is going to come from. Education and management development programmes must ensure nurse leaders have the skill set and competencies to be successful.”
Huston said the ability to achieve a balance
between old and new skills, technology and the human element, national and international perspectives, empirical science and intuition, productivity and relationship, and using power wisely for the bene t of self and others, would be critical for future nurse leaders.
“We must be proactive in identifying, pre- paring and supporting our nursing leaders to address the realities in 2020.” • Huston’s second presentation on the last day of the conference, was a light-hearted look at her own nursing leadership journey and examined her mistakes and what she learnt from them. •
PRISON NURSES WORK IN UNIQUE PRIMARY HEALTH CARE ENVIRONMENT
Prison nurses provide primary health care cerns, with prisoners having to be escorted to drug withdrawal, sex
