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'Fast-track sister programme aims to develop the best leaders'


We’ve embarked on an ambitious project to identify ward leaders from the point of qualification, says Charlie Sheldon

As I recall we started describing nurse leadership rather than management in the very early 1990s; certainly when I did my finals in 1993 the afternoon paper was still called “management”.

In keeping with the student nurse of yesteryear theme, I can still recall my time as a student and the places in which sister was deemed to run a good ward. This “tight-ship” assessment didn’t always guarantee sister being imbued with those leadership qualities we would like to see in our ward leaders today; indeed, quite a lot of student upset was caused on these “tight ships” as we were invariably chastised – mostly in public – for minor indiscretions or lapses in care. Some sisters, however, managed to get it spot on – a presence on the ward, high standards of care and, added to that, a group of staff that felt valued.

We’ve undergone two decades of change in nursing. This has led to investment in leadership development, recognition of the ward leader role as key to a quality service, and a strong body of research evidence supporting this. Unfortunately, despite all of this, there is a general feeling – certainly for many chief nurses in north east and north central London (collectively known as the UCLPartners chief nurses) – that we haven’t quite cracked it.

“We plan to identify, on qualification, those new staff nurses and midwives who have the potential to take on senior leadership roles in the clinical or academic arena”

Of course it’s not just about development, competency and training; there’s also the personal attributes. My friend Jules, who was my senior nurse when I was a newly qualified staff nurse, claimed to have been “born with a sister’s hat on” - while she was making reference to being a sister at 21, actually she naturally had the skills to instil in us a sense of direction, a commitment to maintaining standards and a feeling of wellbeing at work while managing two wards effectively.

So what do we do about it? We UCLPartners chief nurses have embarked on an ambitious project, which aims to identify and develop from point of qualification those nurses and midwives who have the leadership potential and ambition to be our ward leaders of the future. The objective is to provide them with a fast-track programme.

This hasn’t been altogether easy; despite the wealth of information on the attributes of a good leader and the role of the ward leader, we’ve all realised there are several ways to approach this. Specifically these different methods relate to how we measure competency, and how we run a programme that suits different organisations, our personal views and the differing roles in midwifery, mental health nursing, adult and paediatric areas. We’ve certainly all been practising our skills in debate, negotiation and understanding while designing the programme.

We plan to identify, on qualification, those new staff nurses and midwives who have the potential to take on senior leadership roles in the clinical or academic arena. These individuals must also be able to immediately join a bespoke career path across UCLPartners’ organisations. In addition, we’ve designed a specification for frontline ward leaders in order to develop a programme designed for existing and new appointees.

We know things haven’t always been perfect in the past but by using our experience of what has worked – and what hasn’t – and adding to it a modern “fit-for-the-future” slant, we believe this programme will help us develop the best ward leaders in the country. Ultimately, our patients and our staff will be the ones who let us know whether we have been successful in this venture.

Charlie Sheldon is chief nurse and director of governance at Homerton University Hospital Foundation Trust and honorary visiting professor at City University, London


Readers' comments (12)

  • The rest of us will simply do the work then. How nice it must feel, kind of cosy even to know how superior you are. The rest of us plebs will just look at you in awe. We know, when we see our betters, to touch our forelocks. I shall look upon you with admiration, knowing how intelligent you are.

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  • what a load of patronising tosh. 'Born with a sisters hat on'?

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  • More rubbish from a nurse who should know better. If you can't define what it is that makes a great leader then how can you pick them from newly qualified nurses without clinical, teaching, mentoring or leading experiences? Pure academic crap..

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  • HUM BUG!

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  • 'Excuse me,Sister, but we are having difficulty in interpreting this ECG, could you help?'
    'Sorry, instead of learning my role over a number of years in a dynamic, pressurised arena, I have been at college since qualification so I can become a nurse leader. I was chosen because I used to ask the most questions in lectures and had a good attendance record'
    'Could you give me some help with my medicines please Charge Nurse?'
    'No can do, I've never done a medicines round before as instead of learning my role over a number of years in a dynamic, pressurised arena, I have been at college since qualification so I can become a nurse leader. I was chosen because I came top in an exam where I had prior knowledge of the question'
    God help us.

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  • John Howes

    Tally Ho.. one of the doubtful pleasures of having been around a long time is to witness the regeneration after regeneration of the Ward(Sister)Manager. How very true Charli, you haven't cracked it and until you guys at the top realise the Profession continues to diverge along the lines of the practising nurse vs the theoretical nurse then you never will.

    Just before I retired I asked to meet with the Director of Nursing, my reason for this was that as a union rep I was representing a nurse who had failed to respond appropriately to a Cardiac Arrest incident. During the disciplinary investigation I discovered that many of the nurse present were comparably deficient in their knowledge of the situation.

    I apprised the Director of our method of teaching in Critical Care, a method that didn't require mannequins, just a quick impromptu situation where you ask any nurse to respond to" that patient has just collapsed, what do you do next," proceeding to run through the ABC of resuscitation. Takes no time, just a knowledge of what you are doing. She said that some of the Ward Managers wouldn't have the confidence!! In which case the most senior nurse on the ward, whom the world and his wife look up to was incapable of doing the one thing they are paid >£40k, provide leadership. I realised then, it was time to go.

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  • Charlie,

    Would you please come and show me how to manage (sorry I meant to say show leadership) in a large busy busy A&E Department. As an A&E "Nurse Leader " not only does one need all these wonderful leadership skills (I am learning already not to mention that naughty word "management"!) but a significant degree of multi-speciality clinical knowledge and skill.

    However, it would now seem that newly qualified staff will now be identified to enter a bespoke career path. Which leads to what? Being equipped with what ? Skills in "Management Speak?", When and how are these Nurses going to develop their clinical skills? There is no mention of the importance of clinical skill in your short article. I guess these skills are secondary to acquiring "leadership".

    Must tell my brother that he has it all wrong in the Army ! Officers must possess all the skills of the "ordinary private soldier"

    Redpaddys12- you will get yourself into trouble !-Suggesting that clinical skills are important how old fashioned.

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  • redpaddys12 | 12-Jul-2012 9:56 am

    'I was chosen because I used to ask the most questions in lectures'.

    You seem to be implying that asking questions in lectures is a bad thing - asking questions which are highlighting unclear teaching, or better still pointing out that you have just been told something which is wrong, helps to keep the lecturer up-to-speed.

    Perhaps you were thinking of a type of question, I myself didn't often ask as a student - although I will admit to having been known to ask 'I don't understand that bit'. Once, interestingly, I thought about 'that bit' for a couple of minutes, and then said 'where does that come from ?'. The lecturer said 'I've just spent 2 minutes explaining that, what were you doing' and I said 'thinking about it'. Anyway, about 30 seconds later, as he went through the stuff on the board, I said 'Oh, cracked it, I was thinking about one bit backwards - sorry, yes, its obviously right' (now I've stopped being thick) - at that point, after having heard a 30-second interchange between the lecturer and me, almost everyone else in the room interjected with 'we don't understand, it now'.

    It is surprising how (although this wasn't the case there - I had made an error in thinking, as opposed to his stuff on the board being wrong), if someone says 'I didn't really understand that', quite often a lot of others will admit the same thing.

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  • Anon 12.08
    Yes, and I also think good attendance at college is a bad thing. I think you need to read it again, especially between the lines, with your thinking cap on not the pointy one with the big 'D'. I'm not surprised you used to ask a lot of questions in class.

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