In the Spotlight
Monika Gawthrop, RNBN
Manager of Patient Care, GH5/RR4, Reconstructive Plastic Surgery/ENT, Manitoba Firefighters Burn Unit
Health Sciences Centre
What does a typical day look like for you?
A typical morning involves preparing for the HSC Surgery Program’s daily bed flow meeting by connecting with the night staff, listening in to the CRN shift hand-over and reviewing patient care with our Surgical Resident teams. Our GH5 staff gathers for a 10-minute huddle to review the day’s projected clinical activity, flow, and to discuss any updates/ issues. Once those ward based plans are in motion I check-in with the clinic staff to provide support in this high volume patient care area.
What led you to the particular Unit you manage? And what is it that inspires you to stay?
My nursing experience includes adults, pediatrics, the operating room and ambulatory care. The clinical specialty in every area was mostly Reconstructive Plastic Surgery and Burn Care; it is a natural fit for me to manage these inpatient/outpatient areas. I’m drawn to both the lack of routine and the diverse creativity involved in reconstructive after a cancer resection or a trauma injury. The resilience of both the cancer and burn survivors keeps me inspired to stay here.
Your engagement scores reflect a highly engaged team. What are you doing to create those conditions?
I am most proud of the consistency of our engagement scores over the past three years. The positive scores may be a reflection of our long term trusting, respectful team culture and a commitment to Collaborative Care. “Speaking Up” is encouraged and feedback is acted on.
What role does the nurse manager play in influencing engagement?
A manager is similar to a coach that ensures players are in the right position and that each team member clearly understands their role and everybody else’s. On a continual basis a manager also works on developing depth through recruitment and training. Clarity promotes alignment of the staff members which facilitates a trusting culture and can positively sway engagement.
What advice would you offer to a nurse manager working to improve engagement on their Unit?
My advice would be to focus on something that maximizes your credibility with the team which can promote the building of positive, trusting relationships. Consider span of control and what you really enjoy doing because you are probably good at it! I also strongly encourage that all managers accept Milton’s invitation to “Speak the truth to Power.” At HSC I have experienced very positive changes as a result of it.
What small change could a manager make today to improve engagement?
Communicate . . . again and again! Share with your staff what improvements you are working on but make sure they are aware of the “big picture” in your organization. It takes time for positive changes to hit the front line but they still need to hear things are moving in the right direction.
Nurse managers can only do so much. How do we share responsibility for engagement?
I believe our team’s high engagement is as a result of our trusting, respectful culture. Our surgeons are true partners with me in leadership. We share responsibility for a safe culture. Bad behavior is dealt with swiftly regardless of role or “status” of the team ember. Check your ego at the door! Physician engagement is essential to successful staff engagement.
Nurses give a great deal of themselves in their work, it’s demanding and can be emotionally draining. How do you and your staff manager that? Are there specific ways you’ve found to refuel and recharge?
Our team refuels by taking a grassroots approach to employee recognition. We publically celebrate success. Examples may be acknowledging a CRN- led complex team discharge, a grad nurse after the first burn dressing, our housekeeper for turning over many beds efficiently, or a resident who passed her final exam. In clinic we reflect frequently on the phenomenal numbers of patients cared for in our Surgeon, Procedure, Nurse, and Emergency Plastics Clinics. We recognize the fact that our nurses practice to their full scope. Fewer patients are waiting in the ER, on a surgical wait list or requiring a hospital admission as a result of the Plastics Clinic Team.
Who have been your mentors? Do you look outside the field of nursing for inspiration?
I was very fortunate to report to Helga Bryant for a few years; the impact to my career was significant. Her authentic leadership style navigated me to consider a manager role.
What gets you up in the morning, and keeps you coming back?
2016 marks my 30th year practicing at HSC; it really doesn’t feel that long! The patients, families and their stories are what keep me at the front line of management. I need to see the positive clinical outcomes first hand. It is in particular a real privilege to work with the GH5/RR4 staff; they challenge and motivate me to improve every day.