One Nurse Leader’s Story in Leading Caring

So what does this Leading Caring thing look like?

Let me introduce you to Marlienne – one of the best examples of a caring leader.  She is a director of critical care in a multiple hospital system in North Carolina, and has been for several years.

Marlienne is the embodiment of Caring Science.  It is a way of life for her.

She immediately understood how to apply her learnings from Jean Watson’s Human Caring and Healing Certification Program in Colorado back in 2004.  Marlienne was sent there to learn the program and bring it back to her hospital in New Jersey.  But that hospital closed before she had a chance to roll it out.

That didn’t stop Marlienne’s commitment to using caring theory and processes in her leadership roles that followed.  As the director of an EMS program for two years, she applied these principles in teaching EMTs.  She was able to see the impact of her integration of caring theory in the way she taught.  Several of those students went on to pursue higher education and careers in healthcare, despite troubled pasts for some.

When her husband died, she applied caring processes in her own life through self-care and care of her family.  This was life saving for her.

In her leadership position in the critical care units in North Carolina, she took caring leadership to a new level.  In Marlienne’s words, she leads with love, “that’s it, that’s all I do.”

Here’s what that looks like for her …

Upon arrival into this new leadership position, Marlienne started applying caring theory and processes to nurses in her daily ongoing conversations.  By this time, she couldn’t Not do that.

Her conversations were about the nurses – how they were, what was going on in their lives, and then what were their plans with their patients, how were they comforting them, how were they allaying their patients’ fears and sometime aggressive behaviors,  … and while going through these questions, she was also evaluating their clinical knowledge, etc   Marlienne kept notes to help her stay on track withe each nurse.

Soon she started writing  newsletters about caring principles in patient care, in relationships, and in self-care.

She could see that nurses started to respond to these principles with a growing personal understanding, and she saw clinical practice start to evolve.

This didn’t come without a bit of disruption in the organizations status quo.  In fact, Marlienne almost got fired in the first year.  As she was weeding out bad players, the “higher ups” started to notice the high turnover rate, and asked, “who is this person?” Marlienne held firm that her focus was clinical standards and attitude towards patients, and that this turnover would continue until she was rid of the bad players.

It took 3-4 years before she started to see a collective change in the unit in terms of clinical outcomes, relationships among the nurses and physicians, and culture.

Marlienne does not have an education department that is dedicated to caring principles.  Interestingly, all she has ever done in caring theory education is in orientation.  Marlienne hands out a one pager that describes the caring theory and caring principles based in the Caritas ProcessesTM

Leadership development with her nurse leader team does not involve formal education; it’s just ongoing conversations about her beliefs, worldview, principles and  goals.  When nurses pursue higher education, she certainly guides them to Watson’s caring theory and Caring Science.  Many have gone on to higher education and positions. Yes, it is painful to see them go, yet this is part of her profession life plan.

Marlienne is passionate about caring theory and processes, and threads them through every conversation day in and day out.  “The nurses mainly got it from me originally; now they get it from me and the rest of the staff.”

Here’s what her daily routine looks like…

She claims that the main thing she does differently is that she’s out in the unit all the time. Marlienne’s routine:

  • Comes in at 8ish am on most days.  For the night shifts, she comes in earlier on some days or stays later to interact with them.
  • She does not go to her office upon arrival.  Sits down at the nurses station through the mornings– opens her email, reads them and does work at the station.  This gives nurses and physicians the opportunity to access her as needed.
  • She commits to having 2-4 meaningful conversations with individual staff /day; and keeps notes on each.
    • Meaningful= how is your life?, kids?, dreams?, how can I help you?
    • These notes turn into a personal/professional ongoing plan on every staff  that direct her relationships with each

For several years now, she has had a waiting list of nurses to work in her units.

Marlienne tells a story about her relationship with the CEO.  After one trip to Boulder, Colorado for a Caritas Conference, she brought back a gift of Buddhist prayer beads to the CEO, and explained how to use them for self-care.   After a while, the CEO asked Marlienne if she could get him another string of beads because his son had taken his.  Over time, she learned more about the son and got him other Buddhist gifts from Boulder.  The son is now in college with his Buddhist prayer flags.

Recently, one hospital administrator said to Marlienne, “you have so much power in this organization.”  She responded, “Power, what do you mean by power?”   He said, “yes, power, because you have the ear and the hearts of the staff.”


image courtesy of raw pixel

One thought on “One Nurse Leader’s Story in Leading Caring

  1. pmcclendon says:

    From Jae Sanders-
    THIS was the game changer for me
    Finding out what was important to each nurse that worked for me. NOT a work related conversation, a “how are your kids”, “did your husband get the promotion”.


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