For Kearny County Hospital

LEADERSHIP
INTERVENTIONS

Chris Payne
LDRS 811
 Needs assessment – Leadership direction

Kearny County Hospital is a rural hospital in Southwest Kansas that has managed to

avoid the plight of many rural and critical access hospitals. They have more than doubled the

amount of births and see over 21,000 patients, more than double the amount of people in

Kearny county. While that is great news for this small hospital and the towns it serves, they still

face many challenges that urban hospitals don’t. For instance, rural hospitals see a greater

percentage of patients who are sick, and have fewer well visits, which can be more financially

burdensome on a health-care system. Low occupancy can also be an issue when there simply

aren’t enough people to keep a hospital open. (Muus, Ludtkey, & Gibbons, 1995) They are also

challenged by having fewer interested providers, administrators and other professionals who

are willing to stay long enough to develop a patient base (Commins, 2015).

As such, many leaders, particularly mid-level leaders and managers find themselves in

leadership roles much sooner and likely with less training than those within an urban setting.

Employees who leave often blame poor leadership as a primary reason, and without proper

leadership training and experience, employee retention can drop dramatically.

A recent study revealed that Nurses in leadership positions have a more organizational

focus with a master’s degree. Personal growth and development focus with a bachelors and

task focus with an associate’s degree. Leaders with a higher level of education tend to think at

an organizational level. (Baxter and Warshawsky, 2014).

I inquired about the levels of education that the current leaders have, ask about

personal growth tracks and goals the leaders have set for themselves and compare that to what

the executive level leaders expect, have trained and have set as goals for their managers and
see if those expectations line up with each other. These questions and research performed are

specific to managers leading within a rural hospital.

The organization this research project is centered on is a rural hospital. But not just any

rural hospital. Kearny County Hospital is a successful and growing rural hospital that sees more

patients than they have people in the county. They have managed to recruit excellent

providers, recruit and retain valuable nursing and administrative staff and have even been able

to draw people from areas with larger hospitals and towns.

Quantitative Survey Results

Leaders were selected based upon availability and willingness to participate in the

interview process. The CNO (Chief Nursing Officer) of Kearny County Hospital selected the

leaders interviewed and I took an entire day and utilized my phone as a recording device and

had access to a conference room.

The participants were selected because this is a growing hospital in an isolated rural

community who lead a staff of people in an area that isn’t known to grow or draw in good

leaders. As the hospital grows in beds and patients served, I inquired as to how these leaders

felt about the growth, whether they felt equipped to lead and the methods by which the

hospital is investing in these leaders.

In my research performed at Kearny County Hospital, I was attempting to qualify the

factors surrounding the success of the hospital. While the CEO has certainly been a catalyst to

the nearly unheard-of success of a rural hospital, there are many other factors that must be in

place for a hospital to not only grow but retain talented and qualified professionals. This

growth and quality employee retention is also a result of leaders who are prepared and
understand their roles as well. In this study, I attempt to find the factors that contribute to the

success.

Of the seven leaders interviewed, three had their associates. Two of those three are

nurses and the other manages a branch of food services. All three leaders who had their

Associates explicitly stated that an Associate’s degree offers no leadership training whatsoever.

The degree focuses specifically on the tasks involved within nursing on a general level. My first

interviewee stated, “It’s not in-depth ‘cause there’s just so much to learn in the nursing

program”, (lines 12,13) referencing the brevity of the program and amount of content just

devoted to nursing practice itself.

The three leaders with their Associates degrees all mentioned mentors as extremely

beneficial in helping them navigate leadership challenges, primarily in regards to staff

interactions and disciplinary actions. One mentioned length of experience as beneficial to

leading. She said, “I don’t think it had anything to do with it” referring to her degree. She

continued, “My work experience had everything to do with it” (182,183). That same leader

mentioned trial and error as an effective method for growth as a leader.

All but one of the interviewees mentioned a meeting in which they read leadership

books and have conversations about them and found that as valuable continued leadership

investment by their direct reports. (85-86, 231, 369-370, 477, 629-631, 869-873)

The leaders with their associates degrees all expressed interest in continuing to lead in

the areas in which they are the most familiar, with mentions of continuing to develop the

culture and see the growth of their area in which they are currently leading as their highest
goals for their careers. One interviewee stated, “That’s where I want to go and change the

culture where I’m at, not sure if I want to go up any higher.”

Another three leaders received a bachelor’s degree and all made mention of valued

leadership education and training as a part of that degree. All three felt equipped and qualified

to lead because of the education they received within that field degree’s field of study. “I

would have to say my classes in the OML (Organizational management and leadership) helped

me with leadership more than anything I’ve had through the hospital…” (271-272) commented

one interviewee.

Two of the three bachelors-educated leaders cited their education as beneficial in

solving leadership related challenges (320-322). All three leaders with their bachelors

mentioned mentors as helping them acclimate to their current position. One leader who has

been around longer than others mentioned that their entry into leadership at KCH was more of

an immersive experience rather than a calculated, informed move (304-306).

One of the bachelors-educated leaders expressed concerns about people in leadership

positions without a bachelors, but only cited vague concerns about them having leadership

“struggles in certain areas”. This leader also made mention of her own challenges early on in

her leadership, so the suspicion towards non-bachelor’s educated leaders may have to do with

her own personal experience.

Only one of the leaders with a Bachelor’s degree expressed any potential interest in

advancing beyond their current position. The other two expressed concerns that they might

not be in an area in which they are passionate and continue to focus on the culture within the

department in which they currently lead.

One of the interviewees has their Masters and felt like it gave them excellent leadership

training. She felt like it prepared her well to lead meetings, give presentations and understand

how to communicate information to a variety of listeners. Because her job is so varied, she felt

like specialized training was needed in areas specific to certain areas of the hospital. While a

Masters degree prepares an individual for leadership in a generic sense, more training is

needed to navigate the specifics of a particular job. While time in the organization and on the

job is will help an individual excel in their role, having a degree that provides the framework for

leadership will better equip a leader to respond and learn on the job. For example, Day,

Fleenor, Atwater, Sturm and McKee (2014) mentioned that “whereas time and experience are

not mutually exclusive – it does take time to gain experience – it is important for scholars to be

mindful that using time as proxy for experience is limited” (p. 66).

She noted that because of her training within the organization and the requirements of

her job, she is able to learn from the CEO things that are specific to the hospital. She cites

mentoring as a key aspect of what the hospital offers as far as continued education and

learning. She also notes that in regards to leadership training, the hospital does not offer any

in-house leadership training besides a leadership meeting that discusses books, which is

helpful, but not as in-depth as it could be. Most leadership training is outsourced to Kansas

leadership center. While this is an excellent resource for leadership, it is periodic and does not

address the specific needs of the hospital.

In regards to experience, she notes that it is valuable and combined with a Master’s

degree she feels more equipped to be successful in her current role at the hospital. She states,
“I feel like, at this point now, I have some experience and kind of know how to motivate and

mobilize people.” (833-844) Because of her schooling, access to successful mentors, and

experience, she feels the strong desire to continue to move up within the organization as she

desires to create an organization-wide culture of environmental awareness and understands

that with a higher position comes greater influence.

A great start

Investment in leaders Investment in Leadership

Book Study Mentoring
Outside Seminars
Workships
Table 1.

Based upon the interviews conducted, managers and leaders find value in a leadership

meeting that goes over books that discuss leadership concepts. In these meetings, leaders

relate to topics from each book, share and apply their knowledge in a community setting where

they can provide input from their own personal experiences. All but one of the leaders

interviewed mentioned that meeting and reading as a positive impact on their leadership.

From a leader with her associates to another with her masters degree, leaders at KCH found

value in a dedicated time in which they discuss leadership concepts centered around a

particular book they are reading together. This is one of the ways that KCH invests in leaders.

Leaders at KCH also found tremendous value in conferences and seminars put on by

outside sources that were leadership focused. By sending managers to these events, the

hospital communicates to their leaders that they are valued and worth investing extra

resources.
 Not only does KCH invest in individual leaders, but they have also invested, at least

minimally, in starting to create an environment where leaders can thrive. The hospital

continues leader growth with the mentoring of leaders. Over half of the leaders interviewed

mentioned access to a more-seasoned leader has been helpful to their personal development

as leaders. This is beneficial in improving the leadership capacity of newer leaders and helps

instill the existing DNA of KCH into newer leaders. Assuming the mentors are quality, high-

capacity leaders themselves, this is a strength that can pay dividends for generations.

Areas for Improvement

Kearny County Hospital has done an excellent job of breaking free of the typical woes

that are known to plague rural hospitals. They address the individual needs of a leader when

the realization of a deficiency appears. However, there is minimal attention paid to actually

creating a leadership culture. Being proactive in understanding what leadership challenges

currently exist and assessing the current crop of leaders will help this hospital deal with

leadership problems before they arise. KCH will continue to need to be proactive in the area of

leader development if it is to continue to not just survive but succeed the often-changing world

of health care in a rural environment.

To start, A position should be created that will solidify KCH’s commitment to leadership

and leader development. Then, KCH will need to create an over-arching policy of leader

development and establish goals for that program. This will need to start with a succession

plan for all leadership roles and work backwards from that goal. For instance, does KCH want

to have a successful leadership pipeline that will help develop the next COO, CNO, CFO and

CEO? If so, an assessment of qualities currently valued and desired should be the driving force
to examine the current leaders underneath those positions and either recruit or develop

current talent to achieve the desired result. From there, then ask the same questions of those

currently in managerial or directorial positions and build into those roles. This will not only

ensure a culture in which valuable knowledge is passed on, but hopefully it will create a culture

where employees feel valued enough to ensure long term loyalty.

Once a leadership pipeline is established with established goals and policies, then a

directed leadership program should be installed in house to develop current and future leaders.

However, as important as the above suggestions are, the creation of a dedicated position for

leadership will be essential to make those things happen. The current leadership book-study

could be integrated into this program with a clearer focus. For instance, if it is desired that

nurse-leaders grow into not simply positional leaders but relational leaders, then the material

studied should focus on that particular direction. There are lots of excellent books on

leadership concepts. Understanding the particular needs of KCH and then creating a program

around that will keep the focus and narrow the material covered in these meetings.

Executive Summary

Much of the current success is due to a talented CEO who brought groundbreaking

policies to this rural hospital which enticed young, talented medical providers to move to the

area, but in order to have sustained success and growth, a directed strategy is required.

Kearney County Hospital is a non-profit county hospital run by a board of directors. The

hospital employs around 275 people which are led by an executive team of CEO, COO, CFO and

a CNO (Chief Nursing Officer), and managed by a group of 25 people who operate in a

leadership capacity of some form. It offers an Emergency Department, a MedSurg department,

an OB department, Surgery, Endoscopy and outpatient services. KCH currently serves over

21,000 patients, which is greater than the population of Kearny County. They are currently in

conversation with a highly regarded architect for plans to expand all of their services. In order

for this to be successful, they have to have the leadership structure and staff in place to sustain

the projected growth.

In a recent qualitative study of a sample of leaders from Kearny County Hospital, I asked

questions centered around their leadership experience, desire for continued education and

what the hospital offers for leadership and career growth. From those interviews, I was able to

assemble together a list of strengths and weaknesses. First, I will address the strengths and

later in this paper, I will address the weaknesses and submit an action plan to strengthen the

organization in these areas.

Vision

In order to understand strengths and weaknesses, the vision of the organization must be

taken in to account. I contacted the CEO and CNO of KCH and while they have stated objectives

for developing leaders, none of those objectives have concrete strategy behind them. That

being the case, I want to highlight some things I think they are doing well and address areas of

concern that need to be developed.

Strengths

Any organization that has, at the very least, begun to ask the questions surrounding how

to improve as leaders is going to find themselves in a better place down the road than those

who have not. In this part of the country, it is rare to find an organization like this that is

looking in to the future and trying to see what they are going to need to do to continue to be
effective. One of the answers to that question is a leadership book club. KCH, at least with its

nurses, has established a leadership meeting that meets every week to discuss concepts

presented in leadership books and discuss how to best apply them. The leaders I interviewed

all expressed appreciation for this time as being helpful for their growth as leaders. Regardless

of their education level, the entire sample of leaders stated that this was beneficial to

improving their leadership in their particular area. This approach would most certainly be

beneficial to other areas than nursing as well.

A majority of the leaders interviewed also listed leadership training seminars,

workshops and conferences as a useful source of leadership content. By sending leaders and

managers to these events put on by national and state-wide leadership organizations, they

were able to get input from outside sources and experts on leadership and ask questions and

glean experience from other leaders to help support current practices or shift gears on less

effective ones.

Another area where KCH excels is in the area of leader mentoring. Van Velsor,

McCauley and Ruderman (2010) state that “Developmental relationships are consistently

among the second-most cited cluster of learning experiences.” Many leaders shared that one

of the most helpful tools that the hospital has provided has been a mentor within the

organization that could help them navigate specific situations, especially inter-staff conflict.

Managers and leaders found mentoring to be especially helpful when they were first getting

started. These developmental relationships reduce the frustration early on in a new job and

are often crucial when employees are considering other places for employment.
Weaknesses

To start, KCH will need to create an over-arching policy of leader development and set

goals for that program. This will need to start with a succession plan for all leadership roles and

work backwards from that goal. For instance, does KCH want to have a successful leadership

pipeline that will help develop the next COO, CNO, CFO and CEO? If so, an assessment of

qualities currently valued and desired should be the driving force to examine the current

leaders reporting to those positions and either recruit or develop current talent to achieve the

desired result. From there, then ask the same questions of those currently in managerial or

directorial positions and build into those roles.

Once a leadership pipeline is established with a goal, then a directed leadership

program should be installed in house to develop current and future leaders. The current

leadership book-study could be integrated into this program with a directed focus. For

instance, if it is desired that nurse-leaders grow into not simply positional leaders but relational

leaders, then the material studied should focus on that particular direction. There are lots of

excellent books on leadership concepts. Understanding the particular needs of KCH and then

creating a program around that will keep the focus and narrow the material covered in these

meetings.

Learning Objectives

Since establishing a pipeline for leadership encompasses many of the weak spots within

KCH’s leader and leadership development, this is where I will start. By no means should this be

the first step, but this should be a top priority. By establishing these expectations and
standards, KCH can start to build a pool from which they can draw leaders (Van Velsor,

McCauley, et. al., 2010)

Objective 1

Establish a Leadership Pipeline

If building a culture of leadership development is desired, there needs to be

expectations for people at certain levels of leadership. While this may not be possible for the

highest executive level positions, having a pathway for a goal-oriented person to take will

create a system that will help the organization know if the process leads to the desired result.

Performance

Start with each department’s executive leader. What are the qualities and expectations

for that leader. Once that is addressed (this could be accomplished by simply looking at the job

posting for that role), work backwards. Who directly reports to that leader? What are their

expectations? Once that is determined, measure that standard to the person currently

occupying that position? Do they meet that criteria? Honest conversations at the executive

level may need to happen at this stage. Do the people currently serving in their leadership

positions meet the desired expectation? If the answer to this question is “yes” across the

organization, then the process currently in place is working.

Is the answer no? Then a couple of avenues must be taken. First, does the employee

possess the capacity to perform at the desired level? If not, perhaps another role may be

preferred for that person. If so, identify the areas that need improvement and take steps to

address them. Since there is no in-house leadership development organization, find a partner

who may have the tools to help provide the needed tools to this employee.
 Repeat this process until you get to the employees not operating in a leadership role in

a departmental or otherwise position.

Criteria

In the development of this leadership pipeline, several meetings will need to occur.

First, at the executive level, defining the standards for each level of leadership. For many

departments, this will then require meetings with department heads and shift leaders to assess

the performance of those they lead based upon existing standards and then develop a process

to introduce the new standards if they are desired.

Condition

These meetings can either occur during normal work hours or at a work retreat if more

focused time is desired

This objective addresses a couple of concerns. The first is a known, objective source and

process from which they can develop leaders. From this document they can be clear in their

communication to those who have either expressed interest in leading or they can go to a

leader that shows promise and give that employee a clear path to take in regards to their

growth as a leader.

The second thing this does is play to the strengths of an organization that already has a

couple elements in place, specifically a mentoring program and a book study. The pipeline will

absorb both of those elements and make them an integrated, scheduled and purposeful part of

a larger culture of leadership development. As they stand currently, they appear to be an

addition to a daily routine instead of an integrated part of a process.

Objective 2

Establish an in-house Leadership Development Team

As it currently stands, leadership gaps are filled in with sporadic conferences, workshops

and seminars as they are identified. In order to address the necessary processes and

trajectories for the current leaders, a position must be created that will help to not only create

the steps but also cast vision for individual leaders.

Performance

In preparation for growth, assess what will be expected of each department as it grows.

Once those items are identified, communicate with each department what will be expected of

them and determine if they currently meet those measures. For some organizations it may

mean increased staff. For others, improvements may be needed on certain ratings or scores

performed by outside organizations. Evaluative thinking must be introduced beforehand so

that leaders aren’t blindsided by a potentially different standard of understanding success (Van

Velsor, McCauley, et. al., 2010)

Criteria

An understanding of the developmental levels of KCH’s leaders will be important. Is the

leader of the mindset that leaders are made or that they are simply born that way (Avolio &

Hannah, 2008). Part of this goal can be accomplished in the prior goal by assessing the skills of

leaders versus the expectation of the leadership pipeline. Does the leader meet the new

standards? Would this leader be a good fit to be a part of the in-house leadership development

team? Once all of the existing 25 leaders are evaluated based on the standards of what will be

required as growth occurs, then a comprehensive plan and targeted plan for each leader can be
created and implemented by the in-house team utilizing experience, books specific to the

needs of what is being addressed and off-site training, seminars, and workshops as needed.

Condition

These conversations should happen parallel to the leadership pipeline development as

much of the information will overlap.

This objective directly addresses not only the leadership culture but direct development

of the leaders themselves. It builds upon the strengths of the existing staff who function as

mentors, but also challenges everyone to grow as leaders as anticipated growth occurs.

Objective Three

Establish a position completely devoted to leadership and leader development

Based upon the needs expressed earlier in this paper, a position should be created that

is devoted entirely to developing the framework or how leadership is developed, coaching and

mentoring leaders on how to coach and mentor and processing data and structuring course

corrections from surveys and questionnaires.

Performance

This position will work with those assigned to the in-house leadership team as described

above in objective two. This role will create an in house process using already existing feedback

tools like a 360-degree feedback survey and other resources to produce a method for gathering

feedback for leaders so they can learn and grow in their leadership. This position will also work

with those already in mentoring roles to refine the current process and make it accessible to

any leaders in any leadership role. The person in this leadership position will take the results of
the feedback and use it to make course corrections in departments or with specific leaders so

that they begin to align with the mission and values of the organization.

Criteria

This position will need to carry responsibility and authority of at least a director-level

position. They will need to have experience in how to conduct surveys, create an environment

of complete confidentiality and have the freedom to coach executive-level leaders. The person

who fills this role will need to exhibit an understanding of the culture of both a rural,

Midwestern community and rural Hispanic community as the population of Lakin, KS, where

Kearny County Hospital is located is nearly 65% Hispanic, specifically from Mexico. This leader

will also utilize existing resources from the Kansas Center for Leadership as a template or

launching point while bringing the KCH leadership team up to full functionality as a proactive

department. The results of this position should be hospital that is prepared for the future as it

will have a healthy group of leaders prepared to lead, greater employee retention and will be a

model for how hospitals can function and adapt in changing times.

Condition

The creation of this position should happen just before the leadership pipeline is

implemented and the in-house leadership team is developed. This position will address the

need for a creation of a leadership culture and develop individual leaders as coaching and

mentoring improves and becomes more accessible.

Learning Objectives: A brief review.

The first learning objective is to establish a leadership pipeline. In order to create a

robust leadership program within the organization, parameters must be set so that

expectations are presented to those in leadership positions and goals should be set by both the

leader within the pipeline and those who they directly report to. During the hiring process, it is

important to identify individuals who are goal oriented and then have a structure already set in

place so they can apply those goals and feel like they will have something to go after and feel

like the organization cares about those goals as well. This objective speaks to the leadership

development part of this intervention. Creating SMART goals for each department based upon

job duties before hiring another person would be essential. A SMART goal is specific,

measurable, achievable, realistic and time-bound. Following this structure would ensure that

they do, in fact, have their people in the right positions for growth.

The second learning objective fits within the first. Once the leadership pipeline is

established an assessment process needs to be established to determine the ability and

capacity of either existing leaders or new hires. There are many assessment tools available that

could be adapted for use at Kearney County Hospital. Discovering how leaders process, how

they perform under stress and experiences that they have learned will help place leaders on the

“rights seats on the bus”. (Jim Collins, 2001)

The final learning objective involves forming a leadership development team. Currently,

there is no over-arching, cohesive process for developing leaders. The closest thing that exists

are job descriptions that may address what the hospital needs now, but doesn’t address how to

raise up leaders in current positions. This team may require existing leaders to wear a different
hat, adjust hours to devote proper time to the process or hiring a person solely dedicated to

steering the direction of leadership development. While there will be added expense, the cost

savings of not having to replace leaders who leave would more than make up for it in a short

period of time. According to the Chief Nursing Officer, the cost to replace a nurse leader is

approximately $50,000 to $60,000 for each one they have to replace. It would be very easy to

justify the cost of this position considering the cost of replacing a leader who has moved to

another facility.

Table 1.
Intervention Strategy Success Measure Data Point

Establish Multi-method  Leaders stay with  Employee retention.

leadership pipeline the organization.  High-level leaders started
 Leaders have a in entry-level positions.
clear
understanding of
skills and character
needed to make
the next step in
their career.
Establish an in-house leadership  Job descriptions  Trackable hours spent on
development team and include leadership leadership from task-
processes. activities based job descriptions
 Internal leadership  Goals created from
assessment assessments
 Stretch  Data from 360-degree
assignments feedback
 Mentoring  Increase in mentors and
 Continuing mentees
leadership  Employee survey results
initiative
assessments
Establish a leadership  Tangible  Compiles data, reports to
development position commitment to executive team, provides
leader and confidential feedback to
leadership leaders
development
  Return on  Compare cost of salary
Investment and benefits to cost of
replacing employees.
Compare employee
retention to years prior.

Intervention Strategy #1

Establish a multi-method leadership pipeline

Establishing a leadership pipeline would likely require a mix of methods. Specifically,

developmental assignments, developmental relationships, and formal programs. At a hospital,

many roles require formal programs, like LPN, BSN, and the host of degrees required to be a

doctor. But even outside of those roles, Bachelor’s, Master’s and Doctoral degrees give their

students a larger, organization-wide perspective that high school and associates programs do

not offer.

Because of the strength of existing mentoring assignments given to leaders who have

expertise and experience in certain areas, these professional relationships could be leveraged

and included in a leadership pipeline to give formal recognition to a process that could be

expanded to anyone who shows leadership promise. This would obviously require establishing

standards for both mentors and mentees, but this could be built into a job description at a

certain level. Mentoring can also help shape what could be a negative experience into an

opportunity for growth. If a leader makes a mistake, having a mentor help instruct that leader

on how to proceed will create a learning experience. In fact, tying this hardship to a self-

assessment process could be helpful in creating a wake-up call for a leader (Van Velsor,

McCauley, & Ruderman, 2010).

 Developmental assignments could also be a part of a leadership pipeline. In order to

move from an assistant or managerial role to a director level position, the leader being

considered or groomed for the next position would be required to train and lead at an assistant

or manager level in another department that would fall under the role that the person is being

considered for. This would help them not only master their leadership techniques and style by

applying it to a different (or similar department) but also increase their versatility as a leader

and transfer their skills to the new department. (Van Velsor, McCauley, & Ruderman, 2010).

Activity

Creating understanding and processes around both vision for employees and the hospital itself

will start to shift the culture from simply working at the local hospital to embodying the vision

of Kearney County Hospital from the CEO to the most recent hire in the dietary department.

KCH should begin the process by creating an executive team which will compile job

descriptions, compare against existing leaders and directors and future plans for growth for the

hospital and start to develop standards for each layer of leadership and report their findings to

the board. These should include education requirements, methods and standards for national

accreditation and necessary compliance, and leadership attributes. Ideally, candidates should

already possess the requirements for the next level if they are being considered for promotion,

but a team should be in place to consider exceptions if a vacancy creates unsafe or negligent

conditions. The first step of legitimizing the pipeline will be to make sure that leaders who

currently occupy leadership position meet the criteria being proposed. Once that is

accomplished, then rolling it out to the rest of the organization can be done with greater

integrity.
 In establishing a multi-method leadership pipeline, building mentoring into a layer in the

pipeline will offer two benefits. First, if mentoring is a requirement for a certain leadership

position, it requires that the leader to be relational. Can the leader adequately assess,

challenge and support another employee? If not, then they will need specialized training and

feedback so they can become proficient at it. If that leader is unable or unwilling to adapt, then

that inability or unwillingness will hold them back. Second, if that leader cannot mentor or

coach well, then the organization doesn’t have to worry about duplicating the culture of that

leader because they will not advance further into the organization. It is essential that a learning

environment be created and there be room for both success and failure. If a mentor creates a

culture where the mentee feels the freedom to fail, that person will likely be willing to dream

beyond their current capacity. Van Velsor, McCauley and Ruderman (2010) suggest that the

mentor have the ability to take a non-judgmental posture when it comes to providing feedback.

Formal programs should already exist for nurses and other skilled positions. Integrating

these programs in to the leadership pipeline will make integrating the pipeline into the

organization seem like less of a huge jump. Nurses have clinical ladder assignments that focus

on certain areas of healthcare and help increase the base pay that nurses earn. If a nurse is

applying for a leadership position, tying those clinical ladder assignments to not just pay but

leadership should increase the importance of those programs.

Creating a culture of feedback and training leaders on both how to give and receive it

will be a crucial step in creating the pipeline. I will provide further detail on feedback in the

next activities section. Not only will this help direct leaders on how to grow but will help them

help other leaders learn to grow as well, creating a culture that reproduces itself. Healthy
feedback processes can have an exponential effect within an organization if implemented well.

Obviously, this will be a resource intensive process, but any cultural change and paradigm shift

is worth being intentional and investing heavily in. Van Velsor, McCauley, and Ruderman

(2010) recommend that more than one method be employed in creating and processing

feedback.

“Multiple methodologies and activities provide experiences that accommodate a variety of

learning styles. These might include assessments, videotaping exercises, outdoor problem-

solving experiences, coaching, peer feedback, senior executive interviews, journaling, small

group dialogue, large group discussion, and goal setting with online follow-through. These

combined methodologies provide multiple opportunities for participants to gain insight into

and make changes in their mental models, individual behaviors, and impacts on others”

Intervention Strategy #2

Establish an in-house leadership development team and processes

Kearney County Hospital would then want to implement some sort of assessment for

both its existing leaders and those whom it would hire. An honest understanding of the

effectiveness of leaders in categories such as self-awareness, leadership strengths and

weaknesses, knowledge, skills, and attitude will help to tailor on-ramps in to the leadership

pipeline itself. If a leader is at a managerial level but is unable to come up with solutions for

interpersonal conflict between her/himself, then that will need to be addressed and a plan

implemented to help that leader acquire that skill before they are promoted and it becomes an

even larger problem. The efficiency and effectiveness will increase as long as the organization

and its leaders are developmentally ready for what is next. (Avolio & Hannah, 2008)
 This assessment could be approached from a couple of different angles. KCH currently

uses Kansas Center for Leadership for leadership training. Perhaps KCL could help the hospital

develop an assessment tool that would be useful for getting the playing field level and then

utilizing that data to provide feedback for leaders. Developing the culture where 360 feedback

becomes useful will take time but outsourcing the initial process to KCL would keep them from

reinventing the wheel. This assessment should include the following questions:

1. What do I feel like I’m doing well?

2. What would those who work for me say I’m doing well?

3. What would those who work for me say I need to work on?

4. What would my direct supervisor say I’m doing well?

5. What would my direct supervisor say is my biggest challenge currently?

6. What can my direct supervisor do to help me?

The answers should be compared to their supervisors and subordinates responses from a

similar survey. Goals will then be created based upon the challenges listed in this survey, and

leaders will be able to better encourage employees in the things they feel they are doing well.

Job rotations could also be useful in this strategy as well as the first. Moving a leader to

a department that is deemed “more difficult” may stretch the leader to either innovate and

succeed or stumble, and both of those experiences can be used to direct a growth plan for that

leader. It would only be considered a failure if either the leader or organization failed to learn

from the experience. Luthans and Avolio (2003) would consider this to be an authentic leader

development moment that could define or change the leaders leadership potential. This could

also be referred to as a “stretch assignment” (McCauley, Van Velsor, & Alexander, 1977) in
which a leader takes on the task as a potential benefit to the organization and a role that is just

a bit out of reach of the leader.

Understanding the size and scope of this undertaking, KCH will need to assemble a team

that will be able to develop the policies and processes required to establish a healthy, self-

sustaining leadership culture. The team should consist of existing leaders, current employees

that exhibit leadership potential and representatives from each department so that leadership

practices are beneficial to each department within KCH.

As there is no division or department specifically designated to take on the task of

leadership development, a team should be assembled to develop standards, assess leaders and

create a set of objectives that match the vision of the hospital and will develop leaders to

ensure a healthy future for the organization. Since there is already an informal and well-liked

system of mentorship already established, those who’ve been identified as mentors could be

the core of this leadership development team. Utilizing the method of developmental

relationships, these mentors can initially share what worked and what didn’t work and start to

put a structure around a formalized mentoring process that could be built in to the job

descriptions of higher level leaders.

This team could initially consist of higher level leaders but would likely need at least one

or two staff members dedicated to the development of systems like a peer learning process or

a community of practice in combination with other local hospitals. Van Velsor, McCauley and

Ruderman (2010) state that when regularly practiced, these leaders not only become excellent

and versatile leaders but even transfer those skills to their organization. In this case, the rising

tide truly is raising all of the ships.

Activities

Creating a leadership team within Kearney County Hospital will be crucial to developing

an intentional leadership culture. By not having a leadership development team, the culture of

leadership is left to chance in hopes that good things are caught and bad habits are discarded.

An intentional leadership development team can identify and multiply good habits while at the

same time identifying unhealthy habits through feedback and mentoring and correct them in a

healthy way.

The first step should be to identify how many hours should be devoted to leadership

development early in the process and then apply those hours to both the administrative staff

and leadership job descriptions. This may require either an activity-based job description for

many employees or at least a time study to see what can actually be expected of them. This

activity-based job description should include tasks organized by daily, weekly, monthly and

quarterly organization-wide schedules. Intentionally applying personnel hours devoted to

leadership development shows a serious organization-wide commitment to creating an

intentional leadership culture.

A large portion of these hours, at least initially, will go towards training in feedback

programs. Kansas Center for Leadership should be consulted as Kearney County Hospital

already has a working relationship with KCL. Time should be allocated for developing a 360

feedback process (mentioned above) that is relevant to current leaders while at the same time

works towards growing leaders in multiple capacities to meet the standards of the leadership

pipeline.
 This will require multiple employee surveys, the first of which should include the

following questions:

1. What leadership initiatives work for me?

2. What leadership initiatives are not impactful for me?

These can either be answered in essay form or create a ratings structure for each leadership

initiative.

Once compiled, this will help assess the success of existing and historical processes. This

will also provide clues about what language to use so that future surveys and processes won’t

mimic failed or abandoned prior attempts.

The leadership team can then start to develop an ongoing feedback process that

evaluates training sessions, place emphasis on future sessions and develop specialized training

for specific areas of leadership. This ongoing feedback process should include questions like

the following:

1. Do I feel like KCH is investing in my success as a leader? Why or why not?

2. What initiatives have been the most impactful for me as a leader?

3. What initiatives did not help? Please explain why.

4. What do you feel is lacking from your leadership development?

Intervention Strategy Three

Establish a Leadership Development position

KCH will need to create another position who has both the responsibility to gather,

assess and validate the data and the authority to correct non-compliance and direct future

action. While the development of the process is crucial, having someone to drive it is even

more so.

Hiring at least one staff member dedicated to leadership development will be vital,

especially at the launch, as processes will need to be defined and collaborated on by every

department within the organization. The person occupying the position would work closely

with the executive leadership (CEO, CNO, COO, and CFO) and the hospital board defining

expectations for leaders at all levels and developing the standards for compliance within their

own organization, in addition to researching standards for compliance for regional or national

certification for similar organizations. This role would also include coaching higher-level leaders

on how to lead leadership “huddles” of the leaders that these directors oversee.

Both the hiring of someone to develop a leadership culture and the allotment of hours

to dedicate to leadership conversations from existing employees will require an organization-

wide cultural shift and months of training for the board and executive-level leaders to begin

having conversations with their leaders.

Activities

This strategy should be implemented before strategies 1 and 2. The leadership

development position should formalize existing leadership programs and systems and

coordinate with the leadership development team to apply the leadership pipeline, mentorship
program and current formal programs into a cohesive process. A large portion of this job will

be initially devoted to developing and applying the feedback process described in intervention

strategies one and two.

This should begin with the employee surveys, then compilation of the data, and then

applying and adapting it to already existing processes in collaboration with the Kansas Center

for Leadership. Once the 360 process is decided with the leadership development team, then

the person in this position will begin to work with each department head on how to roll it out

within their respective departments. This will also help develop the feedback process for the

individual leaders as the partnership between this new position and department head will

reveal observed strengths and weaknesses in the leader.

This leadership development-focused employee will create systems that will create

accountability for achieving goals and will drive conversations with leaders. This position will

also document evidence of progress and provide support for challenges.

Return on Investment

Simply making changes for the sake of making changes is often the perspective of those

whose work flow and time management are deeply affected by those upon whom change is

inflicted. Many valuable resources will be required to make the changes submitted in this

report, including money and employee hours. Words like “culture” and “environment” are

difficult to put numbers to and are often rejected by those who are responsible for the budget.

Improvements in leadership development are obviously beneficial to organizations that desire

or need to grow, however, these values can seem subjective and difficult to measure.
 One measure that could be used to quantify the monetary value of leadership

development would be employee retention. A leadership pipeline gives visionary leaders,

learners and future-thinkers a place to go. Many leaders are gifted at launching, whiles still

others are gifted in managing and growing. Providing a place for leaders who gifted at all of

those things creates a future in which employees can see themselves growing and learning. A

recent conversation with the CNO (chief nursing officer) at Kearney County Hospital revealed

that the average cost to replace a skilled worker equates to about $50,000 to $60,000 of

combined employee hours, training and money spent. What if KCH, with a developed pipeline

and established leadership development team and personnel, could reduce their turnover rate?

That would certainly be a measurable, tangible statistic to prove the value of the culture

change.
Jack Phillips and Patti Phillips (2006) suggest five levels (p. 143) at which return on investment

can be measured.

Table 2

Levels of evaluating return on investment

Evaluation Measurement focus

1. Reaction and Planned Action  Measures participant satisfaction with leadership
development and measured planned actions

2. Learning  Measures Changes in knowledge

3. Application and  Measures changes in on-the-job training

Implementation

4. Business Impact  evaluates changes in business impact measures

5. Return on Investment  compares program monetary benefits to program

costs.

Obviously, some of these results will come back in the form of 360-degree feedback, employee

surveys and leadership data collection, which is built into the activities required for learning

objectives.
References

Avolio, B.J., & Hannah, S.T. (2008). Developmental Readiness: Accelerating leader
development. Consulting Psychology Journal: Practice and Research, 60(4), 331-347.

Baxter, C. and Warshawsky, N. (2014) Exploring the acquisition of nurse manager competence.
Nurse Leader Magazine. Mosby (2).

Commins, John. (2015). Rural healthcare and the challenge of population health: The issues
facing rural providers are significant, but leaders are creating ways to survive in the
changing healthcare environment. HealthLeaders Magazine. 15(3), 77-108.

Day, D.V., Fleenor, J.W., Atwater, L.E., Sturm, R.E., & McKee, R.A. (2014). Advances in
leader and leadership development: A review of 25 years of research and theory. The
Leadership Quarterly, 25(1), 63-82.

McCauley, C. D., Van Velsor, E. & Alexander, J. (1977). Center for Creative Leadership handbook
of leadership development. Vancouver, BC: Wiley.

Muus, K. J., Ludtke, R. L., & Gibbens, B. (1995). Community perceptions of rural hospital
closure. Journal of Community Health, 20(1), 65-73.

Phillips, J.J. & Phillips, P. (2006). The Handbook of Leadership Development Evaluation.
Retrieved from https://ebookcentral-proquest-com.ezproxy.fhsu.edu

Velsor, E.C., McCauley, C.D., & Ruderman, M.N. (2010). The Center for Creative Leadership
handbook of leadership development. San Francisco, CA: Jossey-Bass.
Appendix B: Transcript of Interviews

M = Me
I = Interviewee

Interview 1

M: In what ways has your educational background prepared you to take on leadership roles
within your organization?

I: Um, so, for my educational background, um…I did, of course the ADN program at Garden City Commented [C1]: Associates degree
Community college and they do talk a little bit about leadership as nurses, um….in that program
you do go through a small section of leadership through one of your semesters. It’s not in
depth ‘cause there’s just so much to learn in the nursing program. Commented [C2]: Very little leadership in associates

M: Oh my gosh, yes.

I: Um, yeah, I was going to say, I think you’ve probably experienced that with your wife, right?
So, it’s a lot. Um….so, in a way, it didn’t really prepare me totally for this position. Now, for a Commented [C3]: Education didn’t prepare for leadership
charge nurse position on the floor, yes. But as for a director of nursing services, no. Not at all. role

M: Okay *laughing. Well, that answers my second question. Um, so I guess its what areas did
it not prepare you for and why? Specifically, the differences between what you got there and
what you have here.

I: Like I said, because there’s so much information you have to learn because in the nursing
program, you know, for education, you’re focused on um….patient safety and critical thinking
and okay, so here comes this patient and this and this and this is what’s wrong with them and
all these answers are correct, which one is the most right. And so you’re learning those critical
thinking skills, which do help when it comes to leadership because you’ve got to have that there
with some of the problems you address, but as far as um, showing how to, like an area I
struggled in when I first came here was I wanted to do too much, and I wanted to help them
too much and I didn’t understand where to draw that line, or what tools I could use, or um,.. Commented [C4]: Accidental micro-managing

M: When you say “them”, do you mean those whom you’re leading?
I: Yeah, yes, I wasn’t prepared for that, to a point. Um…I’ve been in long-term care for a lot of
years and I’ve worked under several different DON’s (Director of Nursing) and they actually
made this job look really easy, but once I got behind the door and behind this desk, I was like,
“Holy cow” how did they do this? Because I never saw this side of it, so… um, it didn’t prepare
me to have those crucial conversations, it didn’t prepare you to make choices well, um, there’s
a conflict between two staff members, how will you handle it? You know, it didn’t prepare you
for that.

M: Okay. You use the term ADN, could you define that for me?

I: Um…yeah….the associates degree in nursing. That’s an ADN, sorry.

M: No, that’s fine. Um, how long have you been leading in any capacity?

I: Uh, two years.

M: Two years, okay. Were you leading anywhere before your were employed at Kearny County
hospital?

I: No, um, I worked in a surgery department. I had an awesome team there. We actually all Commented [C5]: No leadership experience before KCH
had kind of the same work ethic and personalities and we had a great leader and I was a
recovery room nurse and our supervisor did an amazing job, and I think it helped that we were
all kind of on the same page with how we did stuff, So, no. I did not.

M: Okay. What did Kearny County Hospital do to prepare you for your leadership role?

I: So, one thing that helped a lot um, when it came to this position, I did not understand what
was expected. I didn’t know what the exact role of director of nursing services meant. The
year I came was the year CMS, center for Medicaid/ Medicare services decided to roll out all
new regulations for long-term care. Um, its been very stressful. And um, I didn’t have the best
mentor at that time- she’s a very, very good nurse, I don’t want that to be construed, but long
term care was not a passion of hers. So it wasn’t what I needed, so what happened was we got
with a consultant who is a long term care guru-she knows everything about it. She did it for a
lot of years, and she’s retired and now what she does is consult with long term care facilities.
So she came in and that started to change around how I did things here. So I finally had, like, a
mentor, somebody to say “this is what you do in long term care, here’s the regulation”. Then Commented [C6]: Mentor for leadership role
KCH put me through Leading Age Kansas, it’s a non-profit organization in Topeka for places with
aging services. They have a center for leadership that’s a year long program, and I actually
completed it in July. And that was the greatest thing in the world. I would do it again in a
heartbeat. Like, the stuff you learn listening to other people’s stories, going to other long term
care facilities, you just learn so much. It was amazing. Commented [C7]: Leadership training from outside source

M: And so, um, I feel like you kind of described in what ways that was sufficient – the
mentoring, and understanding the stories of others and applying those. In what way do you
feel like there were some areas that it didn’t cover, like you had to find things out on your own
or figure this stuff out?

I: Um, yes and no. One thing I didn’t mention that we’re doing here that I absolutely like,
because I do love to read. I can read an entire book in one day. That’s my favorite thing to do
but with kids it doesn’t happen so much any more, but uh, we started a book club with the
book Crucial Conversations and right now, the book that we’re reading, Hardwiring Excellence, I
love that book. Like, I’ve ordered it for some of my staff members and we meet every other
week to discuss it. Okay, what from this book can we apply here, and we’ve started to do that
stuff. So those areas that weren’t so much covered in the center for leadership, I’ve been able
to pull from those books. Commented [C8]: Leadership books read in staff

M: Okay, Excellent. Think of a time when you encountered a leadership challenge that you felt
prepared to tackle. What was it and how did your training or education help you manage the
situation well?

I: Um, Hmm…I’m trying to think of something. So, um. I know there’s been times, but Jesus I
can’t recall them. Um. Oh yeah! I had just gotten home, and I got a call from one of my
supervisors. She said, “You’ve got to get back up here, a CNA and a nurse have gotten into an
argument, they both are crying , both want to leave because they’re so mad at each other. I
was like, “okay”. So I got in my car, drove back up here, and pulled them each in separately and
listened to their side of the story, cause something I’ve definitely learned is that there are two
sides to every story, you should listen before you react. Um, and once we got done I said,
“We’re going to try an exercise that I learned in my center for leadership class called active
listening.” And what it is, is, you face each other, the two of them faced each other and for five Commented [C9]: Apply technique from leadership
minutes they had to actively listen to what the other was saying on how she felt about the training

situation. And then, once that time was up, the one who was listening had to tell her, had to
say back, “Okay, when you said this, I heard you say this.” And then the other one, for 5
minutes got to tell her story, and the other one got to say “this is what I heard from you.”. And
by the endof it, they were actually talking to each other, and they understood why…the CAN
took it as the charge nurse didn’t have faith in her and the charge nurse took it as there were
some nursing things that should have been done, but that’s not what came out of her mouth at
the time. When you’re on the floor, our minds work a mile a minute sometimes, and so it
ended up being a miscommunication. Both staff members had the interest of the resident in
mind, but they didn’t communicate and they weren’t willing to listen to each other until they
were forced to. I felt that was the first time I felt like I could apply a tool and it really worked.

M: That’s very cool. Can you think of another situation where you encountered a leadership
challenge that you felt unprepared to handle?

I: Um, so…one challenged I’ve been faced with a lot lately is I’ve had staff members lose close
relatives to them. This last year, my assistant’s daughter was killed in a car accident and one of
my nurses grand-daughters drowned in a pool on the 4 th of July. And that was something I
wasn’t prepared for. I should have gotten a degree in psychology or something.. along with
this. Because where I don’t feel I’m prepared is …. One area I struggle with is empathy, and if
that was my child, I don’t think I’d be able to function again. And so I’ve been very lenient,
which some of the other staff gets very frustrated with. But I’m like, if it was me, I’d need
someone to be very calm, kind and compassionate with what I’m going through. That’s what I
try to give to them and it comes off the wrong way sometimes, because I…even with the
nurse..she is different than she was before the accident. She doesn’t have much patience, she
gets very angry very easily. It’s just been very, very, very interesting, and I do struggle there. Commented [C10]: Possible chaplain training?

M: So, leading your team through tragedy

I: Yes, especially…that is one thing I really struggle with because I try to put myself in their
shoes and I think about how I’d want to be treated. That’s not working very well.

M: You mentioned earlier about a leadership opportunity in Topeka…The next question may be
answered by that. What leadership training have you had beyond your education and was
leadership training a part of your degree?

I: Um, so, I had the center for leadership , but right now I’m also taking a class that will take me
about a year to complete at your pace to become a board-certified geriatric nurse. Um and in
that there’s a huge section on leadership in aging services so that will also get me um, some
more training in leadership too, and I’ll have that board certification behind my RN title. Commented [C11]: Continued education in leadership

M: Just collecting those initials, huh? My wife has a bunch behind her name too. I get it.
Do you hope to be promoted at some point beyond where you currently lead right now? Do
you feel safe enough to share that with your direct report? Why or why not?

I: Um, I don’t know if I really want to be promoted at some point. Because one, I like aging
services, and to go to an administrator role, I wouldn’t get to do it. Two, this is probably going
to sound bad, but there’s been a huge change in the work force. Huge. Um, and I think there’s Commented [C12]: Not interested in greater leadership
going to be a struggle in the future with “well, that schedule doesn’t work for me, can I come in role

at this time” or, kind of those little things that you’re already seeing and um, we have a huge
nursing shortage in our country in general and it doesn’t seem to be ending and so um, I don’t
know this will always be something I want to do because of that, because of the mentality
change and stress, beause it does take away from my family and my time, and your kids are
only young once. And I don’t like missing out on some things, so as far as going on, I want to
do…my ultimate goal with aging services is to try to make it home for our residents and it be
like “this is the way I did things at home, and that doesn’t have to change when they come
here”. When I get to that age where I might need nursing care, I worked since I was 15, I’m
retired now and I’m not waking up at 6:15 in the morning because it suits the schedule of some
nurse. I am sleeping in, watching whatever show I want to watch. I am doing what I want to do
, because even if my mind or body has failed me, I still have the right to do what I want to do
because I paid my dues. I think everybody deserves that. That’s where I want to go as a leader
and change the culture where I’m at, not sure if I want to go up any further. Commented [C13]: Wants to change culture in her
department.
M: Okay. That’s very reasonable. What are you currently doing to grow as a leader? You
mentioned that earlier as well, right?

I: Yeah, I like to learn and read books, and even after this one, there’s a book called Extreme
Ownership and there’s a second book that goes with it that I want to read as well. Um, it will
be interesting to say what the author has to say. As a leader you can never stop learning. Um,
some people are natural born leaders, and some aren’t, but you can always learn. Commented [C14]: Leaders are learners.

Interview 2

M: In what way has your leadership background or education prepared you to take on
leadership roles within the organization you currently work for?

I: Uh, personally, I don’t think my education had anything to do with leadership. My work
experience had everything to do with it. Commented [C15]: No leadership training in associates.

M: Okay, excellent. What areas of leadership did you feel like your work experience didn’t
prepare you for?

I: Well, I went to school for an LPN, and I don’t think they taught us anything about leadership.
Because most of the time you’re under the leadership of an RN. So, I don’t believe it prepared
me for any of it.

M: Okay, that is certainly fair. How long have you been leading in any capacity?

I: I would say probably the last, um, probably…management leading? I’ve been a charge nurse
for 30 years. Yeah, thirty years.

M: Okay, Excellent. Um, and were you leading before you were employed at KCH?

I: Yes.

M: What were you doing?

I: Charge nurse

M: Okay. What did KCH do to prepare you for your leadership role?

I: Um, I think I had some good mentors. The DON that was here prior taught me a lot. And Sue
Staley taught me a lot. Commented [C16]: Mentors help in leadership training.

M: Okay. Um, in what ways was this sufficient or insufficient?

I: Um… I think it was sufficient. I think some of the stuff you just have to learn as you go. Commented [C17]: Experience as a teacher.

M: Okay. Think of a time when you encountered a leadership challenge that you were
prepared to face. What was it and how did your training help you approach the situation well.

I: Um, I guess just dealing with staff and attendance, and that just comes from many years of
dealing with CNA’s and you learn as you go, you learn how to deal with them and what works
and what doesn’t work.

M: And on the other side of that coin, think of another situation where you faced a leadership
challenge you felt unprepared to handle . How did you resolve it and where did you go for help
to manage it.

I: Um, I think it was probably when I had to deal with a family member, and I used my superiors
to help me because I didn’t know the answers, so I, I feel like here, there’s a lot of people you
can go to for help with the answers if you don’t know what they are. Commented [C18]: Upper management is helpful.

M: Excellent, okay. Um, what leadership training have you had beyond your degree?

I: Um, your dad is having us read some books (my dad is the Chief Nursing officer at this Commented [C19]: Executive leadership is interested in
hospital), some leadership books. We’ve done, we’re on our second one now. Um, as far as investing in leaders

leadership training, he’s the only one I’ve worked with in all my years of working that’s
addressed any leadership issues, or training.

M: Okay, awesome. Do you hope to be promoted at some point beyond where you currently
lead?

I: No… Commented [C20]: Comfortable in leadership role

M: Okay, if you did would you feel safe enough to express that to your direct report?

I: I would feel safe enough to tell them that. Its because he listens well, Mary listens well.
Those are my two people, so I wouldn’t have a problem telling them. I wouldn’t be
uncomfortable. Commented [C21]: Executive and upper management are
approachable

M: Okay. I think you answered the next question already, but is there anything you’d like to
add to what you’re doing to grow as a leader?

I: Yeah, reading those books and learning from them. Commented [C22]: Team book reading viewed as
beneficial.

M: Sure, what are your goals for your career?

I: Um, I’m happy where I’m at. I don’t care to go back to school. I don’t care to…
M: * laughing* Otherwise, you’d be doing this!

I: Yeah, exactly. I don’t care to become any higher on the ladder than I already am. I’m quite
content.

M: Well, that is all of your time that I need today. Thank you for your time!

Interview 3

M: Okay, in what ways has your educational background prepared you to take on leadership
roles within the organization?

I: My educational background is…I have an associates in nursing and a bachelors in Commented [C23]: No leadership in Associates
organizational management and leadership through Friends. I would have to say my classes in
the OML helped me with leadership more than anything I’ve had through the hospital or
leadership classes offered here. Commented [C24]: Bachelors focused on leadership

M: Alright, what areas of leadership did it not prepare you for?

I: Hmmm…. I think maybe sometimes just the day to day ways to talk with different staff in
different ways, a situation I think some more ways to communicate with people would have
helped. Commented [C25]: Communication classes possibly
beneficial

M: Oh, sure. That’s good. Um, how long have you been leading in any capacity?

I: Um, I’m an old nurse, I mean a lot of years. I’ve been here for 18 years, I mean I’ve been in a
supervisor role for that long at this hospital.

M: Okay, good. Um, were you leading before you were employed at KCH?

I: Yes.

M: Alright. And what did you do?

I: Um, before I came here I worked at St. Catherine’s Hospital for a couple of years and I was
not in a supervisor role there. Before moving to Kansas, I was in a hospital where I was, what
we call a house supervisor.

M: Uh, huh. Sure. Uh, what did KCH do to prepare you for your current leadership role? In
what way was this sufficient or insufficient?
I: I, when I first took the position I was..I don’t know, I was kind of talked into it when I first
came. Commented [C26]: Unclear initial job understanding.

M: Okay.

I: Because there was a need and I just uh, fell in love with the patients and how things can
happen here. So, I don’t really think I was given anything to really help me with leadership in
the beginning.

M: Okay.

I: Did I answer that question?

M: Absolutely. So, it was kind of a trial by fire?

I: laughing Yes, yes it was

M: Okay. So think of a time when you encountered a leadership challenge that you felt
prepared to tackle. What was it and how did your training or education help you approach the
situation well?

I: So the training I took from Friends is what I’d be referring to. So like, a task force to come up
with a solution for something and how to have those meetings and filter out the brainstorming
and come up with a solution. Is that what you’re looking for? Commented [C27]: Implemented Bachelor’s training.

M: Absolutely. That’s perfect. How about on the other side of that coin, did you have a
situation where you felt unprepared to handle it, how did you resolve it and where did you go
for help?

I: Oh, I’d have to say terminating an employee. And I went to the administrator for assistance. Commented [C28]: Upper management and executive
level leaders helpful.

M: Okay. Gotcha. What leadership training have you had beyond your degree? Um, and you
answered that leadership was a part of your degree.

I: Mmhmm. Through the hospital we’ve had um, little pieces of leadership training throughout
the years. Whatever the leadership fad was we got a little taste of it, but never the full Commented [C29]: Leadership seminars
experience.

M: Okay. Um, do you hope to be promoted at some point beyond where you’re currently
leading, and then do you feel safe enough to express that to your direct report? Why or why
not?

I: I, uh, I’ve been asked about that several times. I don’t know that I really want a position
higher than what I have. I often think that my title as supervisor might better be called a
director than a supervisor, you know. Maybe you shouldn’t put that on there, I don’t
know…Um, I’m happy in my position.

M: Okay, that’s fair. That’s good. And do you feel safe enough to express those thoughts to
your direct report?

I: Yes. Yeah, I think he knows I’m happy where I’m at. Just, I think would like to see me take
his position one day. Maybe don’t put that in there either. *laughing *

M: Okay, sure, that’s fine. What happens is that this information will get transcribed, but the
transcriptions themselves won’t go to anyone here at the hospital or be a part of the overall
research project.

I: That’s fine. You know, I’m gonna be 57 this year, and I know I’ve still got a lot of good
working years left, but I was see this department in its fullest before I leave, and if I become the
CNO, I would have a broader, more things to take care of. This is my baby, I feel like, and I just,
you know I just, you know I’m passionate about this and I don’t want more than… Commented [C30]: Wants to continue to influence culture
within department.

M: You own responsibility for the culture and want to continue to foster it, right?

I: Yeah. That’s right.

M: What are you currently doing to grow as a leader on your own?

I: Well, I do read my nursing journals and I’m active on list serves with other managers and we
talk about how to handle different situations or similar situations . I would say that’s probably
the biggest way and I, uh, we uh, share a book that William has for us at our nursing
management meetings. We do that also here. Commented [C31]: Team book reading.

M: That’s super important. Okay, what are your goals for your career as a leader?

I:Um, to have staff that want to work here and be happy. To have a happy staff um, you know,
provide excellent patient care that takes patient’s safety first. That would be my goal, um. Commented [C32]: Influence immediate culture within
department.

M: Great. What could the hospital do help your towards these goals?

I: Maybe uh, offering more incentives to get better, or uh different employees to come here.
Um. An incentive package to get nurses to come here. Commented [C33]: More quality employees needed.

M: That’s an excellent suggestion! That’s really good. Okay, well, that’s all I have.

I: That’s it?

M: Yep. Thank you for your time!

 Interview 4

M: Okay, um, in what ways has your educational background prepared you to take on
leadership roles within your organization?

I: Well, um, I have my BSN, so that was a requirement for clinic nursing supervisor. We’ve had
uh, supervisors in the past who didn’t have their BSN and there were some concerns I think
maybe with, you know they didn’t have the educational background that maybe they had
struggles in certain areas. Um, there’s definitely the leadership piece of the BSN I feel, you
know, my education was 10 years ago and I just now am stepping into this role and its been like
6 weeks. But, I think it’s a mental shift for me to go from direct patient care to you know, my Commented [C34]: Bachelor’s degree includes leadership.
nurses are my patients now, essentially.

M: You’re managing the culture of patient care.

I: Right.

M: Good, okay. Um, what areas of leadership do you feel like your degree did not prepare you
for?

I: * laughing * HR. Oh, that’s a tough piece. There are, there’s a lot of… I mean, you’re trying
to deal with…um, dealing with disciplinary action plans, nurses who are not doing, providing
quality patient care, and nurses who are posting to Facebook while they’re on the clock and
that was not in my nursing textbooks. Commented [C35]: Unprepared for HR.

M: No, not at all. Alright, so you made mention of being in the role for 6 weeks, is that how
long you’ve been leading in any capacity?

I: Um, well, in this capacity, yes. I noticed that for quite a few months before switching over, I
noticed that a lot of nurses would come to me with random questions. Um, when I was in
Wyoming for four years, our school nursing program was more of a program than it is here.
There was a nurse for every building, we didn’t share buildings. But as a nurse there, you were
practicing on your own and it was required you have a bachelor’s degree and it was a form of
nursing leadership because you weren’t practicing under anyone. Which is interesting…

M: Okay, well that answers the back end of that question too. What did KCH do to prepare
you for your leadership role and in what ways was this sufficient or insufficient?

I: Uh, that’s a good question. I did not have much of an orientation, but they have really been
good about last week, with your dad, they sent me to a conference in Salina, next week I’m
going to Austin and in a month I’m going to Hays. They’re really good about send you to
conferences that matter, that have good education, with things that are important to your job.
Um, quality measures that we measure in the clinic, or mental health is a huge focus for us in
our community and um, so that’s where we’re going in November. They’re really good about Commented [C36]: Seminars beneficial to leaders.
sending you there, so they’re good about equipping leadership. Commented [C37]: KCH is good at getting leaders training.

M: Okay, think of a time you encountered a leadership challenge you felt prepared to tackle.
What was it and how did your training or education help you approach the situation. A time
when you were like, “Oh, I know what this is!”

I: * laughing * Um, this is probably a lame example, but recently, so flu shots are a big deal this
time of year in the clinic. We have ordered a lot, mucho flu shots. And we’ve received about
12 of them. It is not our fault, it’s the sender. It’s a government program that we order
through and silly details, but they’re just releasing them bits at a time and we don’t know
unless they just show up that they’re here. So uh, its caused some frustration for our nursing
staff and they’re coming to me like “I can’t give flu shots”. Its silly but it’s a huge deal in the
clinic and so, reiterating to them why we can’t and making a plan, so if you need stuff, you
come to me, and I can distribute it evenly. Dumb example but its right here and fresh in my
head.

M: No, that’s answering my questions. It’s fresh to you, so… On the other side of that coin.
Think of a leadership situation that you felt unprepared to handle and how did you resolve it
and where did you go for help?

I: * laughing * We currently have a situation with a nurse and I’m concerned with the level of
patient care that she’s providing. We’re concerned about some decisions she’s made. Um, and Commented [C38]: HR knowledge lacking. This reflects a
so, as far as who to go to…Lacey is a huge help (Lacey is the HR director) she does love stuff like departmental focus vs. an organizational one.

that, but really, where do we go? HR is helpful and also, your dad is incredibly helpful. Um, he
is so… its like, I don’ want to go into too much detail with her, but it will take some disciplinary
action, come up with a plan, you know, and I haven’t done that ever. And we had another
situation not too long ago, we had a new employee who was not meeting expectations and she
knew what they were, she was not doing them, and she was going behind our back on some
things, so we had to fire her. That is painful. And um, Lacey was really helpful with that. And
HR. But that is the stuff I don’t feel prepared for. I don’t know if you even have to fire anybody
in your line of work, but its awful.

M: I have actually. I had to fire employees and volunteers.

I: Oh yeah, well that’s…. *laughing *

M: Yeah, I feel that. I feel that for sure.

I: Uh huh.
M: What, uh, leadership training have you had beyond your degree? You knid of mentioned
that when you talked about seminars that are topic specific to your job. Anything else?

I: Yeah, The seminars, reading a book with the nursing leadership meetings. Commented [C39]: Seminars and books seen as
investment.

M: Okay, cool. Do you hope to be promoted beyond where you currently lead? And do you
feel safe enough to express that to your direct report? Why or why not?

I: Uh, well… I don’t really know. I just started in this position.

M: Laughing *

I: Uh, I, so. My point of view is, how much time am I currently investing? I started working
here three days a week, increased to four, now I’m at five. And I really wanted to be part time
and now I’m not part time anymore. And so, if I …I like this, and I don’t know if I’d even want to
be any higher or not. Commented [C40]: Comfortable in current leadership
position. This may be reflective my relationship with the
CNO.
M: That’s a fair answer.

I: I feel like I could express that to my leaders though. I have no issue with that.

M: Okay. What are you currently doing…..what are you…I can’t talk. That will be fun to
transcribe. Let me start over *laughing * What are you currently doing to grow as a leader on
your own?

I: I: Um, well, our nursing management group is doing a book study, on a leadership book.
Um, I definitely take mental notes. I go to an insane amount of meetings on …for all different
kinds of reasons. I take notes on what people are doing, how they address certain issues, um
what we can do to avoid this or that kind of scenario. Um, ask a lot of questions. I don’t mind
asking a lot of questions. I think that’s important to learn to grow.

M: Absolutely. Super important. What are your goals for your career as a leader?

I: Um, you know, I think gaining trust with my little nursing minions *laughing *, gaining trust is
important to me. Because I want them to know I care about them. And I will take care of them Commented [C41]: Gaining trust. Creating culture.
well, that I have high expectations of them. If they take care of our patients well, I will take
care of them well, you know?

M: Okay. That’s cool. Then what …as you think about your goals, what could the hospital do to
help you towards those goals.

I: Um, uh, I mean, I don’t know that I could think of anything specific. But if there was a
nursing leadership seminar or opportunity to go to something like that, I’d do that. They’re Commented [C42]: More value on Seminars.
pretty good about answering my questions and nursing leadership above me is always ready to
help. So far, they’ve been very helpful. But I’m still really fresh *laughing *

M: Yeah, well, I appreciate you taking time out of your day to meet with me.

Interview 5

In what way has your educational background prepared you to take on leadership roles within
the organization? What areas of leadership did it not prepare you for?

I: I think part of just going to school to be a nurse teaches you to be a leader. I think that’s part Commented [C43]: She has a BSN. Bachelors teaching
of what our education provides us with is some leadership ability because you have to be able leadership.

to work by yourself, following orders or whatever. But you have to be able to make some
decisions on your own. Um, what areas did it not prepare you…. I just can’t think of…Um…

M: Is there some…I’ll dig in a bit later, maybe that will help.

I: Okay.

M: Um, how long have you leading in any capacity?

I: Um, well I started over at the clinic and I worked there for several years and then became the
clinic nursing manager. And had that position for several years until I stepped down. And I
stepped down for personal reasons, not for any other reason. But I feel like that position was
given to me because I was one of the only nurses. Or the only RN and I’d been there the
longest. So then, you know. When it came down to the fact that I didn’t want to do it
anymore, then I stepped down. And um, continued to work over there, and then um, when I
applied for the position over here, I wasn’t aware it was a nursing management position, but
Sue made it a management position…

M: And there you are again..

I: * laughing * Exactly, Here I am again. But its different. Just because I’ve been here for so
long.

M: Okay. So were you leading before you were employed at KCH?

I: Just in the nursing capacity, not with the title of leader.

M: Gotcha. Okay. What did KCH do to prepare you for your leadership role?
I: I think that …I mean, just the support that I’ve had from my supervisors, has given me a lot of Commented [C44]: Mentors
the leadership skills that I have.

M: Okay. In what ways was this sufficient or insufficient?

I: Um, I think that its gotten better. Um, when I was um the nursing manager over at the clinic,
you didn’t have any backing any of that kind of stuff and I didn’t want that position anyway.
But I feel like since I’ve come over here its just gotten a lot better.

M: Okay. So you feel like you have more people to go to?

I: I do. Over here.

M: Think of a time you encountered a leadership challenge you felt prepared to tackle. How
did your training or education help you approach the situation well. So, something came up,
and you were like, “Ooh, I know how to deal with this because blah, blah blah.”

I: Well, the most recent one that I can think of was probably when I walked out to the desk and
two of our staff members were arguing with each other. I asked them both to go into the other
room, or the other office, because that was when my office was over by the nurses desk. And
you know, we discussed it and I told them that yelling at each other at the nurses desk was not
appropriate . We don’t do that, and if we have a problem that they need to take it to , you
know they don’t need to sit out there and squabble, because it causes hard feelings with the
other nurses, with everybody . Because if we allow them to do it, then we have all the
bickering between the nursing staff and that’s something that I just don’t want. Commented [C45]: Lack of mentoring at this time led to
leadership failure.

M: Everybody takes sides?

I: Yeah, it seems like it, and I feel like that’s what they were doing out there. And so I had to, I
felt like I was able to take care of it. Um, I got them both calmed down, figured out what the
problem was um, explained to them, talking about other people, and um, making snide
comments about each other was just not acceptable.

M: Okay. So think of another situation where you encountered a leadership challenge that you
felt unprepared to handle. How did you resolved it and where did you go for help?

I: Um, it would have probably been when I was at the clinic and I had my own issues with of my
staff members. And its kind of the same situation and maybe somebody should have said,
“Monica, that’s enough” * laughing *

M: * laughing * That’s fair. That’s totally fair.

I: So I didn’t handle it, you know. I think a lot of that comes with age, you know. Um,
M: What is it they say about experience? Its that thing you get just after you need it?

I: * laughing * Yeah, yeah! So, I didn’t handle it as well as I probably should have. Because
what I wanted to do and what one of the girls that was sitting next to me that’s a good friend
said to me “I thought you were going to go over the table at her”. And I told here, I wanted to ,
but you know that’s…but you know with age comes that…you know. So I don’t know if…I think
partly the age, and partly having the support from my supervisors helps with that. Commented [C46]: Mentors

M: Yeah, absolutely. That’s an excellent source. What leadership training have you had
beyond your degree?

I: Just the stuff from my supervisors. Meetings and books, that kind of stuff.

M: Okay, Okay. Um, do you hope to be promoted beyond the point you currently lead? Do
you feel like you could share that with your direct report? Why or why not.

I: I don’t necessarily need to be, you know, I don’t know that I want to be promoted. I like
what I do, where I’m at.

M: Okay, do you feel like you’d be safe to express that to your direct report if you did?

I: Mmmhmm… Absolutely, yes.

M: Okay, Um, what are you currently doing to grow as a leader on your own?

I: Um, like in our nursing management meetings. We were reading crucial conversations.
We’ve read some other books that have really helped me personally, because we read, one
person reads a chapter and talks about it. Then we kind of have a round table about it.

M: Okay, cool. And then, what are your goals for your career as a leader and what could the
hospital do to help you achieve them.

I: I mean, just to continue to make myself um, I mean, my biggest thing is I want to support the
staff that’s out on the floor. And if me being in the nursing management role helps that, then I
want to continue to do that. Um, and I think that like, my direct supervisor has been great,
because these books he’s brought to the table and given us to read have helped a lot. I think
just continuing to do that will help immensely.

M: Cool. That’s good to hear. What else can the hospital do to help?

I: Just continue to be supportive.

M: Okay. Well, that’s all I’ve got.

I: Alright.

M: Thank you so much for your time!

Interview 6

M: Okay, in what ways has your educational background prepared you to take on leadership
roles within the organization?

I: You know, in school, actually, and you’ve gotta remember this was back in the 70’s, early
70’s, so, um. Okay, when I was going to school there wasn’t a lot of leadership classes that we
took. You know what has probably helped me the most is um, the organization having some Commented [C47]: Associates, no leadership training.
leadership type programs, and also, Iv’e gone to several outreach classes. Um, to do leadership Commented [C48]: Seminars, conferences.
through these 45 years I’ve been working. So um, I would say that’s what’s probably prepared
me the most.

M: Okay, those are good. Um, how long have you been leading in any capacity?

I: Um, 40 years. Since 76, so uh, 42 years.

M: Right on! Um, were you leading before you were employed at KCH?

I: Oh yes. I uh, I did worked at Syracuse at the hospital. I worked at Ulysses at the hospital.
And I also did sales about 5 years and then I came back here.

M: Okay. What did KCH do to prepare you for your leadership role?

I: We had several leadership um, at first when I came probably there wasn’t a lot. But since
I’ve been here we’ve had several leadership seminars that we’ve done in-house and um, I’ve
gone to several outside the hospital and you know, my association. Commented [C49]: Leadership seminar and professional
associations.

M: Okay, awesome. In what ways do you feel like this was sufficient, and what ways do you
think it may have been insufficient?

I: most of them I’ve went to have been pretty sufficient, gave me good information, you know,
um, to um, take back.

M: To help you lead in the role that you’re in?

I: yeah, certainly.
M: Okay, think of a time in your life when you encountered a leadership challenge that you felt
prepared to handle. What was it and how did you training or education help you approach the
situation.

I: you know I think I see that pretty much daily. Um, with new people coming to work. We
have the millennials coming in and not that millennials are bad, but they just have a different
take on what it takes to be an employee. So that’s been a challenge. But its also been Commented [C50]: Experience and seminars beneficial to
something they’ve talked about in our different meetings, so I think tackling some of those leading

problems with people not wanting to come to work, that have a different idea of work, or that
they don’t feel like they have to come to work is challenging.

M: Sure, I bet it is. Okay, think of another leadership challenge that you weren’t prepared to
handle. How did you resolve it and where did you go for help to manage it?

I: You know, I guess there’s at times theres some things you’re just not quite sure of. I have
one employee that sometimes gives me some problems and I uh, usually go to upper
management and ask for help. Sometimes several different people in upper management.
Human resources, my direct supervisor, um I’ve gone to other supervisors and said, “help me
here, what would you do?”. And so, I would say upper management and other supervisors. Commented [C51]: Upper management helpful.

M: Okay, that’s good. What leadership training have you had beyond your degree?

I: Um, what other leadership training? I’d say going to outreach programs and uh, also my
association.

M: Define what you mean when you say your association.

I: It’s a ANFP and American diatetics association. I belong to two different associations, so I
usually go to their meetings. In their meetings they will sometimes have stuff on leadership and
the role as a leader and that kind of thing.

M: Awesome, that’s good to have. Um, do you hope to be promoted at some point beyond
where you currently lead and would you feel safe enough to express that to your direct report
and why or why not?

I: Do I? Um, in my education probably I’m as high as I’m going to go * laughing *. And uh, um, Commented [C52]: Comfortable in leadership role, but
you know, I guess I stepped out of the box when I started working for Ben and Keith with would consider advancing.

nutritional services, but at my time right now, ehh, I’m getting close to retirement. I’m not sure
I’m really interested in stepping out of my box. I mean…

M: That’s fair.

I: If it came up, I might. I would have to see. I don’t feel 64, but I am. You know, so, um, I
might consider something else.
M: Okay, so would you feel safe expressing that to your direct report if you want to make the
jump?

I: Oh yeah. I think so.

M: What are you currently doing to grow as a leader on your own? You made mention of
attending association meetings…

I: Yeah, and networking with other people doing the same thing. You know I uh, we also
belong to Pioneer health network here and I’ve been involved with that since it started. Plus
my two associations I belong to, um right now I’m president of west district ANFP and so I’ve
done that before, so I think I’ve been a leader in lots of ways.

M: That’s great. What are your goals for your career as a leader and what could the hospital
do to help you towards those goals?

I: Um…You know, like I said, I’m doing…I’m the president of ANFP and so, once I get my term
over with, I’ll be past president for a couple more years, but I’m not looking for anything major
because of my age, okay? But if it came about, if they wanted me to run for president of the
state association or even the national, I don’t know that I’d want to do that. Isn’t that terrible?
*laughing *

M: Nope. Not at all.

I: Partially age, and partially health. I have a heart condition and heart problems and um, I
don’t know. I’m not sure I want to go ahead and go on, I might. And it did come up and I
turned it down um, about a year ago, because I didn’t feel like, health-wise, I wanted to take
that on.

M: Yep. Okay. Well, that is all I’ve got and I really appreciate your time.

I: Well thank you, this was fun.

Interview 7

M: In what ways has your educational background prepared you to take on leadership roles
within the organization?

I: Well, with my newest degree, a masters in public health degree, they know they really did Commented [C53]: Masters focus on leadership of
emphasize it. They had classes every semester on things like negotiations, dealing with organization. Reflected in her career goals.

differences, but it was really more like leadership traning to me. We learned how to do
presentations, oral presentations, written paper presentations, um powerpoint presentations.
Just how to present information to people. Which I found really helpful because I do that all
the time here.

M: In what areas of leadership did it not prepare you?

I: Hmm…

M: So like, things you’re currently doing, you’re thinking, “I really wish I would have learned
“X””.

I: Yeah, I think mainly like the technical medical stuff. I really still don’t understand accounting.
When I’m trying to track money, I don’t really know how I’m supposed to be doing it. That’s
probably the most…I really don’t understand billing… Commented [C54]: Job specific training needed.

M: Does anyone, really? Laughing

I: * laughing *

M: How long have you been leading in any capacity?

I: Well, I mean I did some leadership a long time ago. But mainly since we’ve started
LifeGroups. Has that been four years?

M: It has. Can you believe it?

I: Yeah, and then when I started here, which was almost 3 years ago, I was working on a grant
project within the first 3 months. So I consider that to require some leadership as I’m gathering
information from everyone, making sure they’re getting what they need to get done.

M: Okay, good. So what did KCH do to prepare you for your leadership role?

I: Um, I don’t think …Yeah, the hospital did offer leadership training through Kansas leadership
center back when I was first here, and that was definitely helpful. And through my grant Commented [C55]: Leadership conferences and training.
projects I’ve gotten more leadership training. In that way the hospital allowed me to grow by
giving me these projects to work on. I know the hospital is kind of weak in teaching people
management skills. We don’t really have any in-house leadership training. They tried to get
that going with Karma when she was here, but it just didn’t really materialize. Commented [C56]: In-house leadership training desired.

M: So in that way, its somewhat insufficient.

I: Yeah, I’ve been lucky since my office is right next to Ben’s, I get to see a lot of stuff that a lot
people wouldn’t get to see. So I learned a lot that way.
M: Sure.

I: More like an apprenticeship, almost. Commented [C57]: Mentoring found to be beneficial

M: Yeah, or a mentoring role. Think of a time when you encountered a leadership challenge
you felt prepared to tackle. What was it and how did your training or education help you
approach the situation.

I: yeah, I think… I feel prepared for the grant that we’re doing right now on mental and
behavioral health. I feel like at this point now I have some experience and kind of know how to
motivate, mobilize people. Um, yeah. I’ve had a lot of trial and error experience with the Commented [C58]: Masters degree
wellness coalition because when I took it over it didn’t really function and was just in name
only, so to speak, so, just trying different things and seeing how people respond in meetings. Commented [C59]: Experience
We had a meeting last night and only one person showed up, so that’s going to change how we
communicate, it needs some readjustment. But yeah, its mainly experience. I guess maybe
another example was the walking and biking plan when we needed to present to the city
council. I feel like through my education I was able to create an effective presentation that was
tailored to my audience. And would interest them and bring them on board.

M: Yeah, okay. You briefly mentioned the second part of this question which was when you
encountered a leadership scenario where you didn’t feel prepared. How did you resolve it and
where did you get help?

I: Well, they haven’t all been resolved yet either. *laughing * I do have technical assistance in
my grant writing processes, but they tend to be vague and less specific.

M: Okay. We’ve kind of touched on this a little bit, but what leadership training have you had
beyond your education?

I: Uh huh. I actually started getting leadership training when I was in high school through the
youth group. And that was…to me at the time, I was unsure why it was happening. * laughing
* I sort of started to understand it later in life, and began to understand why it was helpful. The
concept of leadership and understanding that it was an activity and not a position. It was
something that anybody can do. You don’t have to be THE pastor to do it.

M: That answers that well, thank you. Do you hope to be promoted beyond where you
currently lead and do you feel safe to express that to your direct report. Why or why not?

I: Um, yeah. I mean, I have recently been promoted and Ben, he talks about…you know Ben,
he wants to grow, grow, grow! * laughing * His concept is that my department will include
more than just me and that will allow more staff to come up underneath me to do more
projects. So yeah, we’ve been able to talk about that. Commented [C60]: Not only does she want to be
promoted, but her leaders want her to as well.

M: That’s good. So what are you currently doing to grow as a leader on your own?
I: Practicing regularly. LifeGroup. Training other leaders. Reading books. Just getting to talk
to a lot of leaders. With where I’m at here, in a lot of the different projects, I get to connect
with a lot of experienced leaders and I love to ask them questions about how they approach
things, what they see is going on, what are the problems they see, you know. That’s been really
helpful. Commented [C61]: Team book reading, seminars,
meetings.

M: What are your goals for your career as a leader and what could the hospital do to help you
towards those goals.

I: Yeah, Um. My goal is to avoid climate change, long term, and that requires much more
leadership than I can handle at this point. Um, yeah. Really, my strategy and its kind of a
secret…is that the powerful listen to the powerful. So if you want to have influence on people
who are powerful, then you need to be powerful. I mean, I never believed in climbing the
corporate ladder or you know, that kind of thing. I really don’t care about the yuppie lifestyle,
but I really found that if you want a seat at the table where these people are, you need to have
status and a high position in leadership and that’s really part of my long term leadership goal. Commented [C62]: Organizational thinking.

M: That’s a good thing. You want to influence the influencers.

I: Mmmhmm.

M: Well, those are the questions I have. Looks like you have a ton going on here, and I greatly
value your time. If you have any questions, you have my contact information.