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Novice to Expert a Leaders Journey for APRNs and PAs

Posted on November 17, 2020   |   by   |   Advanced Practice Structure, Communication Skills, Healthcare Teams, Leadership Skills APPs

Novice to Expert, a Leaders Journey for APRNs and PAs

Author: Jill Gilliland
Editor: Elizabeth Moran, MSN, RN, CPNP

The leaders journey from novice to expert for Advanced Practice Registered Nurses (APRNs) such as nurse practitioners (NPs), clinical nurse specialists CNS), certified respiratory nurse anesthetist (CRNAs), as well as physician assistants (PAs) includes a mindset change from an individual contributor to becoming strategically minded systems thinker. Expert Advanced Practice Provider (APP- NPs, PAs, CRNAs, and CNS), leaders are skilled collaborators and delegators.  They are strong communicators and coaches who always lead with clarity.  APPs who develop clarity of thought and a clear vision can provide the bidirectional leadership necessary to work at the executive level of the organization to ultimately elevate the needs of front line providers, build efficient processes, and develop a strong retention strategy. 

APP Leaders Skills: Moving from Novice

The APP leaders journey usually starts with strong clinicians who are invested in professional development both inside and outside the organization. When NPs, PAs, and other APRNs first begin the leaders journey, APPs must develop a new mindset to evolve from an individual contributor to a team builder and developer of others. Expert APP clinicians often excel in critical thinking and have expertise in didactic, procedural, and institutional knowledge. When they become leaders, APPs need to expand the tools in their toolbelt to take on new leadership skills at an enterprise level. 

APP Leaders Skills: System Thinker

System thinkers have an enterprise perspective and align with organizational goals.  According to Professor Elliott N. Weiss, an authority on operations management in the Darden Business School at the University of Virginia, “Leaders with an enterprise perspective understand the importance of building not only strategic capabilities, but also creating the right organizational culture.” 

Systems thinkers align the goals of the organization with their own strategic objectives. Understanding alignment is one of the most important places to start in the leadership journey. Before an APP leader accepts a job opportunity, he or she should  evaluate the role, responsibilities, resources, and reporting structure of the job. One of the main responsibilities of an APP leader on their journey is to align the needs of the front line providers with the organization’s goals and objectives. To achieve alignment, APP leaders need to develop strong communication and coaching skills. 

APPs in Leadership: Communication and Coaching Skills

The leadership journey for APPs begins with developing strong communication and coaching skills. According to Oxford Languages, communication involves sending and receiving information.  Leaders start with developing receiving skills and coaches are expert leaders who have mastered the ability to receive information. They can hear others, both verbally and nonverbally, and then help translate what they heard to provide feedback. Most often, the feedback comes in the form of questions to allow the person they are coaching to arrive at insights themselves. Leaders who master receiving information can send information more effectively and support others in their leadership journey. One critical component to this is for leaders to know their communication styles and the style of communication of the people they are meeting with. 

When leaders are sending information during meetings, experts use all forms of communication channels to speak to different styles of communication. This includes verbal, written, visual, and kinesthetic communication channels. Leaders who have clear meeting objectives and send them out before a meeting can then bring a visual summary to a meeting for greater  impact. Examples of visual summaries include roadmaps which illustrate annual goals or department reporting structures. Then, following the meeting it is important to provide a written summary of meeting minutes, including both meeting objectives and the feedback received.  Ultimately, communication skills facilitate effective collaboration among executive leadership, APP leaders, and institutional staff.

APPs in Leadership: Collaborate!

Collaborative leadership, according to Oxford Leadership, “(is) the process of engaging collective intelligence to deliver results across organizational boundaries when ordinary mechanisms of control are absent. It’s grounded in a belief that all of us together can be smarter, more creative, and more competent than any of us alone, especially when it comes to addressing the kinds of novel, complex, and multifaceted problems that organizations face today.” 

APP leaders at healthcare organizations often have the opportunity to be a member and have voting rights on medical executive committees and attend institution wide influential meetings. As a team member at the executive level, expert APP leaders use systems thinking and communication skills to effectively engage with others and accomplish goals. Often, this means learning to have difficult conversations effectively. Leadership collaboration is the result of well developed communication skills, use of logic, and problem solving skills to handle disagreements when they arise. APP leaders who are successful collaborators have learned to build flexible teams and delegate responsibilities to achieve maximum results.

APP Healthcare Leaders Delegate!

The NP, CNS, CRNA, and PA leaders journey is a process of personal development, including growth from being an individual contributor to a collaborative coach. APP leaders become collaborative coaches when they identify strengths in their sphere of influence and then utilize these collective strengths to build teams and achieve goals. Expert leaders effectively delegate by building teams, communicating clear goals and vision, as well as support the work of others without micromanaging the process. 

To build flexible teams, APP leaders need to identify members by developing relations with organizational stakeholders, building an APP council, and building an APP leadership structure. Teams need to have clear, smart goals, and should consider use of a goals system such as  objects and key results (OKRs).  

The leadership journey takes time, support from mentors and the organization, and must be a very intentional process. Within healthcare organizations, APP leadership is also an important and evolving role. As the number of APPs grows in an organization, the need for management specific the needs of APPs increases. APPs have different needs than nurses or physicians.  APP leaders at the executive level with a supportive APP leadership structure and council are a critical capability of healthcare organizations.  Developing APP leaders is a worthwhile investment for the leaders and their organizations. 

For information about building, hiring, or developing APP leaders, please contact Jill Gilliland, President, Melnic. 

APRN and PA Leader Resources:

Advanced Practice Leadership Resources

APP Leadership Articles and Information

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