Every Step You Take, We Will be Guiding You

Purpose: Using human-centered leadership dimension and attributes, ambulatory care nurse leaders developed professional development activities and created a culture of innovative exemplary professional practice. The creativities leveraged professional practice and individual growth, nurse peer mentoring, and a clinical ladder program for registered nurses (RNs), resulting in significant outcomes over a five-year span.
Relevance/significance: Nurse leaders remain challenged during the COVID-19 pandemic to keep nurses engaged while working at the bedside. Elements of the human-centered leadership model of the motivator, coach, mentor, architect, and advocate providing a caring environment that nurtures the nursing workforce through being kind and genuine and building relationships.
Strategy/implementation methods: Strategies were developed and implemented thoroughly, reviewing the literature on professional development, peer mentoring, and progression plans for nurses. These strategies included individual meetings, caring relationship building, webinars, retreats, workshops, small task forces, peer mentor program extension, leadership development and education, clinical ladder evaluation, and expansion. Nurse leaders were mindful and empathetic for nurses to advance on the clinical ladder structure. Nurse leaders developed and redesigned the clinical ladder criteria, checklist, nursing webpage, and career development goal planning forms. Front-line nurses provided feedback to nurse leaders on learning electives that they felt were important to their professional practice. Nurse leaders took this feedback and created a significant list of electives that were added to the nurse's achievements and also included the front-line nurses to serve as clinical ladder champions.
Evaluation/outcomes/research: Through the development of a nurse-centered professional clinical practice ladder, nurse leaders created a culture where professional development is all about the nurse. Over 54 clinical ladder electives are available for nurses. Additional professional development activities were created for nurses to earn two electives. In addition, nurses had the opportunity for a retention elective. Quarterly clinical ladder retreats were hosted. These retreats created opportunities for professional development, as well as opportunities for personal and professional connections. Nurse leaders found value in providing in-person and virtual workshops and monthly twice-a-day webinars for the nurses to attend. A total of 205 nurses advanced on the clinical ladder from 2018-2023. Since being introduced in 2018, there has been a 44.7% increase in ambulatory care nurses who advanced on the clinical ladder over a five-year span. In addition, the nurse peer mentoring program was extended and was offered to LPNs and medical assistants; 89% completed the program in the fiscal year 2021-2022, 73.6% met a SMART goal, and the program had a 97% nurse retention rate. Incidentally, we learned that the higher the percentage of nurses who advanced on the clinical ladder in several of our ambulatory care clinic settings, the lower the nurse bedside turnover rate for that specific clinic.
Conclusion: Using a human-centered leadership approach, nurse leaders reflected upon their self-awareness to find creative ways to help nurses stay engaged and appreciated. Nurse leaders created engagement and professional value through a variety of consciousness of others and synergistic strategies such as professional development, coaching, mentoring, self-reflection, humble inquiry, and kindness.