Bill Klaproth (Host): This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. And today, we're talking about how Connecticut Children's is using AONL's Transition to Nurse Manager Practice Program, or TTNMP, to build a stronger pipeline of prepared nurse leaders.

With me is Kristin Kozlowski, Senior Nurse Manager of Nursing Excellence at Connecticut Children's, and Marge Julian, Associate Chief Nursing Officer and Vice President of Clinical Services at Connecticut Children's. Kristin and Marge, welcome.

Kristin Kozlowski, MSN, RN, NE-BC: Hi, Bill. Thanks for having us today. Hello, Bill. Thanks for having us. It's great to see you

Host: So Marge, what leadership need led Connecticut Children's to focus more intentionally on developing its nurse leader pipeline?

Marge Julian, DNP, MSN, RN: Well, we are always focused on nurse leaders. However, during my doctorate of nursing practice scholarly project, I focused on novice nurse leaders at Connecticut Children's, and we determined that we had an opportunity to implement a nurse leadership development program, and we looked to AONL to help us with that.

And as we implemented that program, and then did a survey, our results demonstrated an opportunity for further development of our nurse leaders, novice nurse leaders, and that led to this consistent program.

Host: And then, Kristin, why did you choose AONL's Transition to Nurse Manager Practice Program as part of your strategy for preparing new and emerging nurse leaders?

Kristin Kozlowski, MSN, RN, NE-BC: Yeah, great question. So as Marge had shared after the pilot group, we really wanted to bring all of our nurse leaders together into a developmental series together. And we looked out there at the nation, and we knew that the success with Marge's pilot group using AONL was really great, and AONL had the program that we needed for our nurses to do this competency development together.

When we met with AONL, we looked at the framework, we looked at the curriculum, and it really met the needs of what we were looking for developing our leaders. And something innovative that we did here was that we had all of our leaders participating in the program together. There were 105 of them total. So, we had experienced nurses working with our novice leaders together in this program, which really helped build that success.

Host: Absolutely. And then, Marge, how did you approach implementing TTNMP within Connecticut Children's? And what were you ultimately looking for the program to accomplish?

Marge Julian, DNP, MSN, RN: Well, as we implemented it, we looked at nurse leaders who, you know, influence and shape care and help our nurses develop. And we really did not only immediate nurse leaders, assistant nurse managers, managers, directors, but we included our educators, and that led to the 105 leaders. And from there, we decided we really needed to include everyone.

So, we included everyone, we involved them all that we did an on-site education, over a period of six months. So, they were together relationship building and learning at the same time. And so, we received really positive feedback. And looking at AONL, that is the gold standard in the and the best benchmark in the country. And so using that education, we had great success and continue to have great success from that.

Host: Well, it sounds like a winning program for sure. So, Kristin, are there certain leadership skills or competencies that have proven most important for nurses as they transition into management roles?

Kristin Kozlowski, MSN, RN, NE-BC: Absolutely. So when we collected baseline data with AONL that we were able to assess all of our leaders' competencies at the beginning of the program, and that was really important. And again, that was framework that AONL provided us, and they gave us the results. So, we could really look and see what tour leaders' biggest learning needs were.

And what we found, which we weren't really surprised about, was the business skills and finance management. And I think part of the reason for that is that a lot of our nursing programs don't have a strong concentration in that, or some of our participants haven't completed a master's degree in nursing leadership.

We were excited that this program was going to help fill in some of those gaps with the finance and business skills of leadership. And then, the other piece in there would be the relationship management and communication, which was another large part of this program. And as Marge had shared, bringing us together in person with this program allowed for that dialogue and for that mentorship to happen, and it also helped with the relationship building and communication. So, it helped with all the different competencies.

Host: So, you mentioned business skills and finance and then relationship management and communication. Are those skills some of the things that make this transition into a nurse leader a little more difficult?

Kristin Kozlowski, MSN, RN, NE-BC: Yeah, absolutely. So when nurses transition to a nurse manager role, you're now responsible for managing a budget and finances and resources, and that's not something that nurses did in their clinical role. So, we find that a lot of times when nurses start in a new manager role, they need help with how do you manage a budget? How do you advocate for resources? How do you make a business plan for needs that you have in your unit? How do you use the technology of our budgeting software? And those are large gaps and needs that our leaders have. So with this program, we were able to use the AONL content and our own internal content of different programs and software we use and blend them to really meet the needs of our teams.

Host: And then, Marge, I would imagine that experienced nurse leaders play a role in helping new participants grow into their new position. Would that be correct?

Marge Julian, DNP, MSN, RN: Yes, that would be correct. You know, experienced nurse leaders, you know, really understand the top areas, relationship building, soft skills. So really, helping them develop them teaching and coaching, and then reminding, leaning into the curriculum. The finance and business skills, really reaching in and leaning into that content and reminding them, helping them with their budget, helping them to understand their business.

You know, the other things that we did, we leaned into the experts within Kankakee Children's who are our business leaders, our finance leaders. They participated in teaching, and so the teams got to learn exactly from the experts. Our quality leaders, our regulatory leaders participated in teaching and developing further relationships with the team to strengthen it. And so, we had much positive feedback from the teams. They got to experience those leaders as well.

Host: And Marge, how important is it then that nurse leaders, experienced nurse leaders stay engaged after the training ends?

Marge Julian, DNP, MSN, RN: It is very important. It's pivotal to success. You're really helping them develop, you know, an independent development plan and helping them to be successful. You're expressing an interest. You're helping them develop, to learn this, to further grow for this. You're also encouraging them to go on for their graduate degree. We've seen many really interested in enrolling graduate programs. But nurse leaders taking interest in their development and helping them is pinnacle to their success.

Host: It sounds like participants can learn from each other and certainly from nurse leaders that that real-world experience that they might not get from the curriculum, and that's where the nurse leaders helping in the education really helps. Would that be right?

Marge Julian, DNP, MSN, RN: Correct. That would be correct. You know, really teaching each other. And if we go back to where we started, developing relationships that you can in the moment call them and say, "Yo, I really need a moment of advice." Or as you sit down with them in your weekly meetings to talk through saying, "How is that going? How is your success going? How does it feel to you? Where do you feel that you're having some challenges? What feels uncomfortable?" And really addressing that one-to-one with them.

Host: And then, Kristin, can you tell us what you've learned through this experience since implementing the program? Can you tell us the change in the impact that you've seen among participants or even within the organization?

Kristin Kozlowski, MSN, RN, NE-BC: Yeah, for sure. So, we learned a lot. There were a lot of really great takeaways from this. One of the biggest takeaways was that our team lead role, and these are nurses who have a blend of leadership, and they still work clinically. They gave us such positive reviews of this program because they had such limited development prior to this.

And so, I think one of our takeaways was to make sure that we're concentrating on that group of nurse leaders as well, that we're including them in development, and that we're putting some concentrated efforts in their development as leaders. And they are our future. That's our succession and our pipeline there.

Some other takeaways was that I would strongly recommend doing these in person. We didn't offer a Zoom option for participants to join, and part of that was really to help with the relationship building that Marge had talked of and those communication skills, because leaders that you don't see often in person were right there in the room with each other. So, that was definitely a takeaway that we will continue with, really having that in-person connection with each other, because that was so important.

Host: So, would it be fair to say, Kristin, then that the TTNMP program has really increased confidence in the day-to-day leadership skills of the emerging nurse leaders?

Kristin Kozlowski, MSN, RN, NE-BC: Absolutely, yes. And that was evidenced too by our outcomes. So with AONL, they give us our competency assessment for our leaders before the program and then after. And we had a very significant increase in all of the different competency domains for all of our nurse leaders, which was really exciting data and outcomes to have. So, we're excited to continue with the program.

Marge Julian, DNP, MSN, RN: And that's true, Kristin, because, you know, as we know when we talked through and taught our leaders, they are transformational leaders, and they are linked to their team's development, which link to patient and family outcomes. And so, we're really able to influence the team members and create enhanced outcomes for our patients and families.

Kristin Kozlowski, MSN, RN, NE-BC: Yeah. And to go off that too, we've had people reach out who participated in the academy and have asked for additional education on a specific topic. So for example, one of the leaders from the units had reached out and asked for a specific area to be talked about at her staff meeting because she thought it would be really beneficial for her nurses to hear about. So, it sort of started a trickle effect, which is really great. And our leaders are asking when they can have more. So, that's a great outcome right there.

Host: Well, it sounds like what you're doing here is you're not simply teaching people how to do the job, you're helping them become leaders. Would that be a fair distinction?

Kristin Kozlowski, MSN, RN, NE-BC: Absolutely.

Marge Julian, DNP, MSN, RN: That would be correct. And we're helping them to transition, understand their role identity as leaders. And then, they're able to further grow and develop all of their leadership traits.

Host: And that just helps the organization overall as well. So really, a winning program.

Marge Julian, DNP, MSN, RN: Absolutely winning program. And then, this really drives that our leaders are very important to us. We are focused on our development, helps us with retention or helps us with recruitment of leaders. And that is a very important part of our institute as well.

Host: Yeah, retention and recruitment. Those are great points, Marge. So, thank you for bringing those up. Okay, last question. I want to send this to both of you. Marge, let me start with you. For other healthcare organizations thinking about this type of succession planning and building a stronger nurse leader pipeline, where would you recommend they start?

Marge Julian, DNP, MSN, RN: I would recommend they start with really looking at AONL. That is our professional leadership association. It is the gold standard. It's the benchmark. And they have a very formidable education that is very successful. It has been adapted throughout the country, and everyone who has adapted it has positive reviews and great success with that. So, I would encourage them to continue to look to AONL

Kristin Kozlowski, MSN, RN, NE-BC: I completely echo what Marge had said, and I also think it was, it was really helpful for us that we included all of our leaders in this because our experienced leaders and our novice leaders were hearing the same messages and the same content. And I think having them build those relationships together in person was really great.

We also heard from participants that hearing their senior leaders talk about their vulnerabilities and what makes them nervous about leadership was really helpful for them to hear as new leaders that, "Oh, our vice president or our CNO also has worries in leadership." And hearing that helped validate their own personal leadership feelings. So, I do think that having the different levels of leadership was really, really beneficial.

Marge Julian, DNP, MSN, RN: And other things we did is, you know, of course, we had the curriculum, but before that, we did a kickoff day. So, we brought leaders together as a kickoff, introduced the education. Our CNO, Sara Matney, really talked about why they were important, why this was important.

We had members of our family advisory council come and talk about why nursing's important and why nurse leaders are important, and how their children and family were greatly really impressed and impacted by nursing. And then, after the curriculum was finished, we had a graduation, and our senior leadership came and thanked everyone and recognized how important this was and how we were really already seeing differences in shaping our care.

Host: Again, it sounds like a really winning program and great examples for sure. And Kristin, as you were saying, hearing other established leaders say, "Yeah, I didn't have all the answers. I had some, you know, things I didn't know," certainly helps build confidence in the other leaders thinking, "Okay, I can do this then." I don't need to have every answer if these people look up to certainly aren't—they're saying they didn't have all the answers. I feel better about launching into this."

Kristin Kozlowski, MSN, RN, NE-BC: Yes, absolutely.

Host: Yeah. Well, once again, thank you both for your time today. Kristin and Marge, thank you again.

Kristin Kozlowski, MSN, RN, NE-BC: Thank you.

Marge Julian, DNP, MSN, RN: Thank you, Bill. It's been great to see you. Thank you for having us.

Host: Absolutely. That was Kristin Kozlowski and Marge Julian. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you at aonl.org/nursing-leadership-podcast. This is Today in Nursing Leadership. Thanks for listening.