CNR NURSES: A Legacy of Leadership
CNR nurses learn more than just the skills necessary to take care of patients. They are taught to be leaders, mentors, and advocates – for themselves, their patients, and other nurses. It’s a legacy of leadership that stays with them throughout their careers.

“Leadership is a basic nursing competency. At the bedside or in the boardroom, nurses have to advocate and lead for patients and other nurses – it’s the cornerstone of our practice,” says Launette Woolforde, EdD(c), DNP, RN-BC, who received a post-master’s certificate in nursing education at CNR’s School of Nursing in 2003.

And she should know. With a master’s, post-master’s, and her second doctoral degree near completion, Woolforde’s 18-year nursing career has spanned a variety of clinical and education positions, and she is currently the corporate director of nursing education for the North Shore LIJ Health System. Being a leader is part of Woolforde’s daily experience now, but she traces her leadership roots to her time at CNR. “Fostering leadership ability in its students is one of the things CNR does very well,” Woolforde says. “The faculty are exemplars of leadership and they create opportunities for students to gain experience and exposure to leadership through nurturing and supportive mentorship. I met Dr. Connie Vance, for example, when I was her post-master’s student at CNR. In the 10 years since, we have developed a wonderful relationship, and her mentorship of me inspires me to mentor others.”

Woolforde is not alone in understanding the benefit of a nursing education that encompasses leadership aspects – indeed, one of the characteristic definitions of the CNR nurse is his or her role as a leader and advocate for other nurses.

Leadership Starts in the Classroom

CNR’s focus on nursing leadership begins in the classroom, and the lessons learned there extend far into the field.

“We introduce the concepts of leadership, mentoring, and networking in the curriculum,” says Dr. Connie Vance, CNR professor of nursing and author of a new book, Fast Facts for Career Success in Nursing: Making the Most of Mentoring in a Nutshell. She points to the “Transition to Professional Practice and Leadership” courses. In this two-course sequence, senior students study leadership and management theories in relation to professional nursing practice, and then apply those principles in a variety of clinical settings.

“But while nurses are taught the concepts, principles, and basic skills of the profession in nursing school, when they step into the next stage and start their careers, the only way that they can adequately learn is through the caring mentorship of other nurses,” Vance says.

“When it comes time to give your first injection or bathe a patient, or speak to family members of someone who is dying – those are not behaviors you learn in the classroom,” says Catherine Graham SN’96, senior vice president of operations at St. Barnabas Hospital, Bronx, NY. “Sometimes it is on-the-job learning, but a lot of it is other nurses who teach you and protect you.”
Graham recounts experiences where nurses have been put in unsheltered environments without any guidance from other nurses and, in a few years, she says, they are looking to leave the field. “How nurses take care of each other and nurture each other is a big deal,” she says.

Vance concurs. Mentoring and advocacy in the field has been shown to prevent mistakes and dissatisfaction among new nurses, promote high quality safe clinical care, and can even boost the notoriously low retention rates for nurses’ first jobs, she notes. “I used to believe that mentoring novice nurses was a nice thing to do; now I think it’s absolutely essential,” she explains.

And, because CNR is educating baccalaureate nurses, the focus on mentoring for leadership is even more crucial, says Dr. Deborah Hunt, assistant professor of nursing at CNR and a veteran nurse who spent 15 years in hospital-based leadership roles. “The baccalaureate nurse is looked to for leadership in hospital positions almost from day one. Even though they may be novice nurses, they have to be role models and oversee the work of ancillary help very early on in their careers,” explains Hunt, who obtained a master’s degree in nursing administration and completed an extensive review of the leadership literature in the development of her doctoral dissertation.

It’s Not Easy Being Green

To help ease this transition from school into the demanding first stage of a nursing career, Vance and Hunt co-founded CNR’s Nurse Advocacy Forum in April 2008. The Forum – whose members are senior CNR nursing students and new nursing alumni – meets four times a year, providing a vehicle for support, advocacy, networking, creative problem solving, and leadership development. It gives students and recent alumni an opportunity to learn from each other and from expert guest speakers.

Vance and Hunt are also documenting their experience with the Forum, collecting data and working to share their insights with other schools and nursing communities who are also interested in bridging that gap between school and practice. They were recently invited to share their work at the
International Research Network for Preceptorship and Mentorship sponsored by the University of Alberta, Canada. “Other schools are interested in emulating this work. It would be great to have national and international projects in this vein,” Vance says.

“We have a lot of wonderful stories from the Forum,” adds Hunt. “Students that were having difficulty with licensing exams or challenges finding and navigating their first positions tell us that the support they received from the Forum, or the inspiration from hearing one of our speakers, gave them the self confidence they needed to succeed. It really is a positive force in so many lives.”

Woolforde is impressed by the group’s focus on bridging the gap between student and professional nursing. “The Forum really helps the students get a picture of what the next few months and years – or whole careers – could look like through the eyes of living, breathing nurses working in the field,” she explains. “That tangible is so critical.”

Mentoring and advocacy in the field has been shown to prevent mistakes and dissatisfaction among new nurses, promote high-quality safe clinical care, and can even boost the notoriously low retention rates for nurses’ first jobs.

Another tangible example of CNR’s focus on leadership learning in action can be found in the CNR delegation that attended the International Council of Nurses (ICN) conference in Malta in early May. Along with Professors Vance and Hunt – who were invited to present on the work that they’ve done with the Nurse Advocacy Forum – and Woolforde, were two current CNR nursing students (undergraduate Shannon Magee Campbell and graduate student Susan Sakalian SAS’86, SN’93) supported by the Russel & Deborah Taylor Foundation Travel Scholarship.

“The ICN conference exposes participants to nursing on a global platform and allows them to see how nurses impact health around the world in capacities that transcend our familiar roles as caregivers,” says Woolforde, who also presented her work at the ICN this year. “It is remarkable that these two CNR students were able to experience this – to learn about nurses leading media and health care; helping reduce low-birth weight and stillbirth rates in babies around the world, and leading and driving access, quality, and health. It is more enriching than any classroom experience, and bringing these students along was model behavior when you want to talk about leadership, advocacy, and mentorship.”

Climbing the Ladder

As they go from novice nurses to veterans and into administrative or educational positions, CNR nurses keep the leadership lessons they learned at CNR close to their hearts. Graham, for example, worked her way up the ranks at St. Barnabas (from nurse to director of nursing to senior vice president of nursing to her current role as senior vice president running hospital operations) but has remained an advocate for nurses.

Watching some of the nurses under her charge struggle to balance their full-time jobs at the hospital while pursuing additional nursing degrees, she worked with CNR to develop a nursing degree program on-site at St. Barnabas. Starting with just 10 nurses, the program has just graduated its second cohort in the nursing and health care management tract. Instructors from CNR teach didactic classes at the hospital and together, they work to place the nurses in clinical rotations.

“When I was an adult learner, I found it very difficult to transition from work to school, and I wanted to make that easier for other nurses,” Graham explains. “These nurses finish their shift and they go to our auditorium and the professor comes to them. It’s a great way to advance the profession and help more nurses pursue their studies.”

The fact that Graham initiated this program for other nurses is typical of the legacy of leadership that CNR instills in its nurses. Summing up the philosophy, Vance says, “We’re building a strong, collegial network of nurses that have the confidence to find their first positions, move through the challenges of the early career stage, and then into leadership roles where they have the chance to mentor and influence other students and other nurses.”