Senior in Nursing (Final Semester in Fall 2016)
Focus on Healthcare Summer II Study Abroad in Utrecht, Netherlands
Course – Nursing Leadership and Clinical Management
This Summer School course of Leadership and Management has been wonderful. The structure of the class – being based on discussion and sharing opinions – was conducive to much self discovery and developing
more self-awareness. This self-awareness is key to the expert roles that we discussed in class, especially the Communicator and Collaborator roles.
Communication seemed to be the overarching theme of this course. Such as, communication techniques and being self-aware to become a better leader. First, I learned and felt that the discussion based on Greta Cummings concepts of emotional intelligence was an intriguing start to the class. High emotional intelligence is important to obtain and maintain through regular practice in both personal and professional life. The Life Coat Exercise was a wonderful pairing to this concept. I felt the exercise growing us as individuals, but also of each other and as a group. We thought of a loss and of a symbol that reminded us of them or it. Through the process of thinking of a loss, and making the symbol, time was provided for us to meditate on the loss but also and more importantly, the good memories. As a result, we shared with each other not only what our loss was but also the lovely memories we made with those people or within the time. We learned what exactly we were grieving within that loss. This requires intense and high emotional intelligence. Not to mention, a vulnerable state of mind and willingness to bear a tender side of yourself to others.
Many of these concepts overlap and create a wonderful, complex web that builds a communicator and a leader. The Johari window is a broad overview of the self-awareness we have and is always dynamic. The more we learn about ourselves and others, the more the respective squares grow or shrink (known, hidden, blind, and unknown). The most intriguing part I found was that the proportions of the windows will be different with different individuals or within different groups, horizontally, vertically and diagonally – the windows will be different sizes for each.
Habitus was an unknown and intriguing concept to me as well. Knowledge of the concept encourages you to ask “what is my natural habitus and what is my artificial/learned habitus?” For example, the first situation I thought of was my first clinical experience in Bronson Hospital. That is my scholarly and professional habitus – my first, and consequently most impactful, experience in the career I’ve chosen. As a result, when I entered Borgess Hospital for a clinical rotation, I found it strange, not normal, and I compared everything to Bronson standards rather than a clean slate. But then I started thinking about all the different types of habitus that we gain as we progress through life including our beliefs about raising children, faith, education, beliefs about living, loving, death, etc. All of these different areas influence and guide how we act and why we act that way in a situation. Of course, this also translates to our actions and beliefs about people from different cultures. Edwin quoted, “All nursing is intercultural nursing.” I believe that is true. No one, even if they are from the same country as you, truly has the same exact culture as you. To be self-aware and to realize what we consider as “normal” in our own frames of reference, is truly communication and leadership at it’s most humble. Awareness leads us to encourage ourselves and others to consider what other’s frames of reference might be in even the simplest of situations.
In progressing to the other role I found most intriguing, collaborator, I remember the concept of low context culture and high context culture. True, this concept can also be applied to the communicator role quite nicely, as the roles blend into one and other seamlessly, but I identified it with the collaborator role even more so. Acknowledging and tolerating differences in cultures especially – learning to be appreciate a high context cultured individual in a low context culture system, such as an American hospital. The trick is to be more efficient with patients that are high context culture while also respecting their beliefs and their lifestyle. In the same way, we need to respect and acknowledge our coworkers context cultures.
As a collaborator, the question that needs to be asked is “what leadership is to me?” I enormously enjoyed the animal exercise! It helped us to think of specific qualities and characteristics of our leadership style, rather than simply saying a natural leader. Also, knowing that organizing work takes up 70% of the time is important to value. Nurses collaborate, communicate and organize patient care of the good majority of their work shifts. That is nursing. Once again, as it was in the communicator role, our habitus and frames of reference affect how we deal with situations and issues as a professional health care collaborator.
Lastly, I enjoyed learning about Hofstede’s principles in both the context of leadership in communication and collaboration. I realized how important it is to constantly maintain your awareness of where you (as an individual), your unit, and your organization stand on each spectrum of Hofstede’s six major concepts. For example, distance to power was my topic to present and consequently I was most intrigued by it. Distance to power is subjective and depends on where you place the power or perceive the power to be and also depends on where you place yourself on that spectrum of power and how close you are to reaching it or affecting it. Nurses are closer to a doctor’s power in terms of deciding patient care and therefore want to know the rationale behind decisions and why the power is allocated as it is. On the flip side, nurses are much higher than patients on this spectrum. Patients usually take the advice of nurses as it is, without much questioning or curiosity.
Daily life outside of class and fieldtrips to hospice centers and hospitals took some getting used to.
One cultural barrier I encountered during the trip was I only knew the bare minimum of the Dutch language. I missed the simple, little details that are so common at home. For example going out to pick up a couple things from the market, mostly I did not understand the overheard conversations surrounding me. That in its self makes for a lonely outing if you go by yourself.
In summary, I enjoyed the constant challenge in this course to what we perceived as being normal, depending on where we come from and our unique backgrounds and cultures. I also appreciated the diversity of the class with many different cultures and countries represented and the smaller size as well. It allowed everyone’s voice to be heard while still providing an opportunity for differences to be seen and appreciated and for learning to take place.