Guiding lights for effective workplace cultures that are also good places to work

Cardiff, Shaun; Sanders, Kate; Webster, Jonathan; Manley, Kim

doi:10.19043/ipdj.102.002

Cited by 9 publications

(25 citation statements)

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“…To the future: action nursing! Thus, to conclude, I believe the Buurtzorg model follows the four guiding lights for effective workplace culture model proposed by Cardiff et al (2020). These are:…”

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confidence: 76%

“…(a) raise awareness of the need to join-up system transformations so every level is cognisant of the others' impact and responsibilities; (b) cultivate person-centredness at micro, meso and macro levels; (c) develop greater understanding of the power and value of an effective workplace culture through using for example the Guiding Lights framework (Cardiff et al, 2020); (d) establish reflective practice/supervision for every nurse and midwife and student nurses and midwives via upstream methods, i.e. legislation; (e) develop person-centred, global curricula; (f) develop greater understanding of new evaluation methodologies to support systems transformation and person-centred practice.…”

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confidence: 99%

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Providing not prescribing: fostering a culture of wellbeing in nursing

Bosanquet

2021

Journal of Research in Nursing

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In November 2020, The Foundation of Nursing Studies (FoNS) and the Journal of Research in Nursing (JRN) facilitated an international debate on wellbeing in nursing (https://youtu. be/ncgtYMBhbiU). An especially pertinent topic as we were 9 months into a pandemic and wellbeing was at the forefront of our professional and personal thoughts. The debate's impact lingered, and it sparked something in me that I have not been able to shake, so when I was asked to compile a special on-line collection of papers published by JRN on wellbeing I leapt at the chance.Quite simply my belief is that wellbeing in nursing is so poorly understood by governments and 'organisations' and at a societal level that we, nurses, need to unite to take action against the surge of displaced responsibility forced on nurses, individually and collectively. The provision of top-down interventions such as wobble rooms, psychological first aid, restorative supervision, helplines etc. to mitigate against workload pressures and slumping wellbeing is not enough. These often-unrequested interventions may be neither appropriate nor usable without root-and-branch alterations to our work environments and cultures, and further evaluations of what works and why.Our sense of wellbeing is depleted: nurses are experiencing compassion fatigue, emotional exhaustion, burnout, moral distress and moral injury. However, taking a deficit approach fails to capitalise on the positive impact which working together to co-produce a tailored, person-centred response could bring. Wellbeing must be taken seriously at all levels, individual, team, organisational, governmental, micro, meso and macro, and we need to work together to achieve greater wellbeing in the global nursing workforce.It goes without saying that wellbeing in nursing is different to wellbeing in the wider population or other professional groups. I believe it is explicitly linked with the four principles of our professional identity: our ethics and values, professional comportment, leadership and knowledge (International Society for Professional Identity in Nursing (ISPIN), 2021). I also believe that we know, all too well, what depletes nurses' wellbeing: values incongruence, lack of autonomy, lack of control, lack of belonging and lack of

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confidence: 76%

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confidence: 99%

Providing not prescribing: fostering a culture of wellbeing in nursing

Bosanquet

2021

Journal of Research in Nursing

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“…Applying reasoning to behaviours and responses in emotive scenarios through resilience-based clinical supervision is a valuable process for stress alleviation and prevention [19]. The need for 'resilience' is often identi ed as a prerequisite when considering workforce transformation, what is less well de ned and understood are the elements that enable 'resilience' from a personal to system perspective, other than the emotional intelligence required for leadership that is hopeful, empowering and builds good relationships [20].…”

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confidence: 99%

“…Effective teamwork is a core component for transformation [20,21]. Recognised by notable cohesion, interprofessional teamwork and community collaboration resulting from a shared purpose and direction in the pandemic.…”

Section: Discussionmentioning

confidence: 99%

System wide learning from first wave Covid 19: A realist synthesis of what works?

Jackson¹,

Manley²,

Webster³

et al. 2020

Preprint

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Background This paper presents a thematic analysis of 176 interview transcripts from front line staff working during the first wave of COVID-19 in the East of England. Methods Presented as a descriptive case study it reflects the complexity and numerous variables that influenced staff experiences of delivering care and support across the health and social care system between April and August 2020. Drawing upon the methodology of realist synthesis, it addresses the question “What works for whom and in what contexts and why?” to help illuminate real-world issues that people have faced. Results Thirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. Four tentative theories of system transformation are presented to highlight support mechanisms that are needed to enable front line teams to be effective in further waves of the pandemic, capitalising on system wide learning, patient, resident and staff wellbeing. Conclusions This paper presents a unique insight into front line staff experiences of working during the first wave of the Covid-19 pandemic using realist synthesis methods to distil key themes and tentative theories about what strategies work to enable and empower front line teams to be effective and to support system wide learning and transformation.

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“…Over the past couple of years, there has been a noticeable philosophical shift in understanding how leadership impacts culture, quality, safety, staff and patient experience in health and social care (Cardiff et al , 2020; Manley and Jackson, 2020; Manley et al , 2019). This shift has prompted debate about the need to identify what works well in both formal leadership programmes, as well as in workplace teams and organisations.…”

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confidence: 99%

Strengthening nursing, midwifery and allied health professional leadership in the UK – a realist evaluation

Jackson

McBride

Manley

et al. 2021

LHS

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Purpose This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University. Design/methodology/approach Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes. Findings Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”. Research limitations/implications This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families. Practical implications The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool. Social implications Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide. Originality/value The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development.

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Guiding lights for effective workplace cultures that are also good places to work

Cited by 9 publications

References 0 publications

Providing not prescribing: fostering a culture of wellbeing in nursing

Providing not prescribing: fostering a culture of wellbeing in nursing

System wide learning from first wave Covid 19: A realist synthesis of what works?

Strengthening nursing, midwifery and allied health professional leadership in the UK – a realist evaluation

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