Once upon a time, in the not-so-distant past, nurses were perceived as people whose job consisted of following orders, and nurses who were racial or ethnic minorities were routinely steered toward dead-end jobs with little hope of advancement. Nowadays, of course, the picture is much brighter. In today’s complex, technologically advanced and bottom-line-obsessed health care industry, opportunities for recognizing the natural leadership abilities of nursing professionals in general, and minority nurses in particular, are growing by leaps and bounds.
“Nurses of color have come of age,” says Edelia de Venecia-Mendoza, MSN, RN. “They are leaders, managers and followers, as well. The public depends on them for leadership and service. Patients today are more ethnically diverse and more members of the health care team are involved in decision-making. The decision-making process is decentralized and more nurses have a part in the decision. I am a believer that leadership is everybody’s business.”
Mendoza, a native of the Philippines with over 35 years of nursing experience, certainly fits the definition of a leader. In 2005 she was inducted into the Sigma Theta Tau International Honor Society of Nursing in recognition of her commitment to global health and the nursing profession. She is also president and CEO of Contemporary Image Network & Services, which provides consulting and professional image management services.
“Nurses need to have people skills, visionary and inspiring skills, and entrepreneurial skills,” Mendoza maintains. “They should be very good at promoting cooperative efforts, sharing a clear vision of where the team needs to go in the future and communicating a clear idea of a desired outcome. Today, the focus of concern in health care is really on the bottom line, and nurses must see themselves as being in charge. By using their influence to produce agreement with others, they can give direction based on positional authority. This is a powerful tool in being a leader.”
Audrey Mitchell, RN, is another minority nurse who knows a thing or two about leadership in nursing. Throughout her 43-year career in North Carolina and Georgia-based health care organizations, this veteran nurse has witnessed the importance of developing leadership attributes in the midst of the sweeping technological, demographic, economic and other changes that are taking place across most health disciplines. Mitchell, who is African American, served as a nursing manager and floor resource contact during her many years as a cardiac and open-heart surgery nurse. She has recently retired from the profession but continues to serve as a mentor to new nurses entering the field.
“It has always been important [for nurses] to develop good leadership skills,” she emphasizes. “They are necessary to meet patient needs and to keep pace with today’s technological advances. As health care professionals, we must work cooperatively and effectively with many kinds of people. Nurses are the voices of patients and families. They must develop and maintain effective human relations, communication, listening and managing skills. Those should all be incorporated into making a good leader.”
Mitchell believes minority nurses can help advance their careers by educating themselves about the leadership roles available in the health care facilities where they work. She also feels hospital administrators should do more to offer incentives to nurses when they observe leadership skills in action.
“As a student nurse or a recent graduate who is headed into the field, it’s a good idea to take a self-evaluation to assess your leadership potential,” she adds. “Many new nurses are working a year in a health care organization and then moving on. Hospital administrators should recognize that and come up with [incentives] to help keep nurses from leaving. Unfulfilled potential can lead to frustration and this causes a gap in leadership.”
How can minority nurses learn to cultivate these all-important leadership skills, or enhance the ones they already have? One way is to observe good leaders in action. Another is to take a leadership development course, seminar or workshop.
Many leadership training opportunities for nurses at various career levels are available, both locally and nationally. For example, the Robert Wood Johnson Executive Nurse Fellows Program offers advanced leadership training for nurses in senior executive roles who aspire to shape the health care system of the future.
For nurses who want to learn basic management skills--such as time management, conflict resolution, mentoring and managing staff--Johnson & Johnson’s Campaign for Nursing’s Future has produced an educational CD-ROM, “The Virtual Nurse Manager.” The CD-ROM is being made available to hospitals throughout the nation. Nurses can also order it free of charge from the campaign’s Discover Nursing Web site.
A particularly exciting development in recent years has been the rise of leadership training programs designed specifically for minority nurses. Lee Anne Nichols, PhD, RN, an American Indian (Cherokee) nurse educator who teaches at the University of Tulsa in Oklahoma, is one of several members of the National Alaska Native American Indian Nurses Association (NANAINA) who worked on the development of Pathways to Leadership, a culturally competent leadership training program created especially for Indian nurses.
“As a Native American nurse, some of the values that I use in a leadership role are not the values of the mainstream culture,” Nichols explains. “Native Americans have different cultural values and beliefs, and each tribal entity has its own unique culture and belief system. I was taught to be humble, quiet and respectful. I was also taught not to speak for others but to seek the opinions, thoughts and concerns of others. Since my values of leadership are different from the [majority culture], I need to know how to be a leader in both the Indian way and the non-Indian way to be successful.”
Another leadership development program created to meet the unique needs of nurses of color is the Minority Nurse Leadership Institute (MNLI) at Rutgers, The State University of New Jersey. The MNLI was established in 1999 through the Educational Opportunity Fund (EOF) program at Rutgers College of Nursing in Newark. This annual series of nine monthly Saturday workshops, taught by some of the nation’s most accomplished minority nursing leaders, helps nurses of color continue their education, advance into leadership roles and use their leadership abilities to improve minority and community health.
The newest of these culturally specific leadership training initiatives, just launched this year, is the Leadership Institute for Black Nurses at the New York University (NYU) College of Nursing in New York City. The inaugural cohort of 14 fellows began the six-month curriculum in January. Each fellow is assigned to a distinguished African American nursing leader who serves as a mentor and advisor. The fellows meet monthly, participate in a monthly conference call and work on individual leadership development projects.
“The fellows have already talked about how much they are getting out of the program,” reports the institute’s director, May Dobal, PhD, RN, an assistant professor at the college. “We’re trying to get funding to extend the program and change it to a year-long [format]. NYU has a rich history with black nurses and we want to do more to include our accomplished alumni and have a continuation of that history.”
The Institute for Black Nurses is modeled on the Rutgers program, but there are some key differences, according to Yvonne Wesley, PhD, RN, FAAN, adjunct associate professor of nursing, who co-conceived the institute with Terry Fulmer, PhD, RN, FAAN, dean of the NYU College of Nursing.
“The minority nurse leadership program at Rutgers is broader [in focus],” explains Wesley, who has also served as a mentor to participants in the MNLI. “A leadership institute specifically for black nurses is genuinely needed.”
For example, she says, many black nurses are still encumbered by “baggage from the 1970s, when racial integration was still taking place in the profession. Our program starts out looking at just that issue. We look at self first, then paradigms of leadership. Many of our participants already have their master’s degrees, but they realize [their careers] are hitting into something [that prevents them from advancing]. We already know the glass ceiling exists, but the black population faces the cement ceiling. [One of the goals of] our program is to chisel away at that ceiling.”
“Black nurses, even those in managerial positions, often feel powerless,” notes Dobal. “For example, when they have the choice, some white patients will choose a white nurse over a black nurse, [because they assume] the white nurse is senior. This makes it difficult for black nurses to have major decision-making roles that affect institutional treatment and health care delivery experienced by all patients.”
Although the institute is currently focused on recruiting nurses from the tri-state area closest to NYU, it is open to nurses in other areas of the Northeastern seaboard whose schedules could accommodate the one-day-per-month meeting schedule.
Of course, not every nurse is in a position to enroll in a formalized leadership training institute. Fortunately, there are many other ways minority nurses can learn leadership skills and gain exposure to nursing leaders who can serve as role models and mentors. For example, nursing association events and conferences can be an excellent source of professional development education, not to mention terrific networking opportunities.
However, Mendoza believes that when it comes to networking, nurses often fail to take full advantage of those opportunities. “What I have noticed at nursing conferences is that the nurses network within their own group instead of with other nursing leaders from around the world,” she says. “You need to expand your own circle. When you attend seminars, conferences and workshops, opportunities to network really abound. There are so many nursing leaders and other career professionals who are innovative and have added so much to the profession’s body of knowledge. You’ll only know that through networking.”
Mitchell agrees. “Nurses should utilize their professional organizations and capitalize on continuing in-service education,” she emphasizes. “They should look for the creativity and recognition of their profession, as well. Be confident, have a positive attitude and be willing to be led as well as being a leader. [Sometimes] it’s a fight to maintain your integrity, to know who you are and what you’re there to do. You need to know you are blessed to recognize what you bring to the field.”
Even your patients can be a source of leadership opportunities. As patient care and resource management continue to jockey for attention in health care organizations, nurses will be called on to demonstrate competence, empathy and professionalism as they seek some balance between these issues. Mendoza feels that daily interactions with patients, the public and other members of the health care team can provide some of the most meaningful opportunities to learn and grow as a leader.
“I’m in close contact with patients,” she says. “I know their needs, what they are concerned about and I pass things on to other [nurses and] doctors. I’m in close communication with other members of the team and I know what’s going on. I consider myself an ‘uncrowned leader,’ someone who can bring information and skip the bureaucracy. You feel the freedom to make innovations and you aren’t going to break the protocols. You are free to speak. Even if you’re in the lowest position in the hierarchy, you must develop your personal vision and mission, and it must be in alignment with your organization.”
Nichols, whose culture places high value on consulting with elders as mentors, believes the best opportunity to grow as a leader must come from within.
“Learn about your strengths and weaknesses,” she advises. “Learn who you are and that who you are is OK. Draw strength from your background, be it Hispanic, African American, Native American, Asian or Caucasian. This is who and what you are, and being who you are will make you a great leader. Be humble and remember we all are always learning and becoming. Also, remember everyone is different. Everyone has a purpose and contributes to the unit, the group, the patient’s care, the institution and the community. Be respectful to everyone, particularly our elders.”
--Minority Nurse Senior Editor Pam Chwedyk also contributed to this article.