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1 Establishing Professional Presence to Promote a Healthy Work Environment Reflection Paper College of Health Professions, Western Governors University D024: Professional Presence and Influence Heidi Johnson-Anderson September 9, 2023

2 Establishing Professional Presence to Promote a Healthy Work Environment No matter the occupation or position, a healthy work environment is what employers aim for in their establishment. This stays true in the hospital setting. As a healthcare professional, I work with diverse individuals with different backgrounds, ethics, cultures, and viewpoints. Even with all these differences, we must be able to work with each other professionally and respectfully to harbor an environment worth working in. When it starts to become unhealthy due to workplace situations, that is when it can affect your work performance, and the quality of care you provide, and it can even affect you as a person. According to Wei et al. (2018), healthy work environments are connected with a decrease in emotional tension and burnout and an increase in job satisfaction and retention. This then means an unhealthy work environment can cause the opposite. By utilizing social and emotional skills, also called power skills, I will be able to manage difficult workplace situations that would cause an unhealthy work environment. Using Each SEI Power Skill to Manage Difficult Workplace Situations Self-Awareness The first power skill is self-awareness. Self-awareness is the ability to understand one’s own beliefs, thoughts, feelings, and emotions while also knowing about another person’s perception or mindset (Western Governors University, n.d.). When it comes to the work environment for healthcare professionals, having self-awareness can impact a person’s interaction with their coworkers more positively and constructively. An example where self- awareness can be used is when there is conflict between two individuals. Any kind of dispute where one person is raising their voice or is becoming more upset can be unhealthy in the workplace. As an advanced professional nurse in this situation, I would know how my emotions and feelings can affect my physical state (e.g., tone, mood, etc.) and professionally discuss the

3 issue. Utilizing this emotional intelligence can then lead to accepting constructive criticism which promotes a healthy work environment (Brou Fossier, 2022). Self-Management The next skill that can be used in the work environment is self-management. Self- management is the ability to be held responsible and accountable for one’s behaviors and actions (Western Governors University, n.d.). One section of self-management that all nurses utilize is time management. Nurses must plan out tasks and care every hour, especially when new orders are made and/or when a challenging situation arises. One example of a difficult workplace situation is when a patient is becoming more unstable, but there are also other patients needing care. Utilizing self-management in this situation as an advanced professional nurse, I would prioritize this patient and take the initiative to notify the physician of any urgent assessments. Learning from such experiences and utilizing this power skill can lead to more controlled behavior and a better understanding of oneself (Brou Fossier, 2022). Interpersonal Communication Our third skill is interpersonal communication. It is the ability to communicate and interact with others, which is essential to building personal and professional relationships (Western Governors University, n.d.). Interpersonal communication is used frequently in the hospital, especially when it comes to teamwork and collaboration. Being an advanced professional nurse, I work with physicians, therapists, assistants, social workers, and many others who are part of the interdisciplinary team. This can be difficult at times as there can be many people trying to discuss things all at once and/or misinformation given by some of the members. Interpersonal communication can be utilized and assist the collaboration process by actively listening, giving input, and directing the team on pertinent information. It can then lead to more positive interactions with my peers (Brou Fossier, 2022).

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4 Executive Function The next skill is executive function and it’s the ability to process complicated tasks, problem-solve, critically think, and utilize information to make the right decisions (Western Governors University, n.d.). When it comes to critical thinking and problem-solving, one difficult workplace situation comes to mind and that is a code blue event. Cardiac arrests can be stressful because tasks need to be done timely, communication must be clear and closed-loop, and there should only be one leader managing the situation. By utilizing executive function as an advanced professional nurse, I can demonstrate the appropriate skills required by me from the American Heart Association. If my role is giving medication, then I must be able to hear the code leader clearly and call back the medication they had ordered. If I am helping with bagging the patient and assessing that the compressor is going at a slow rate, then I must call out and notify them to push at a rate of 100-120 beats per minute. Using executive function leads to better decision-making and is important in these difficult workplace situations (Brou Fossier, 2022). Social Awareness Our last skill is social awareness. Social awareness is how a person reacts, adapts, and participates in any social setting (Western Governors University, n.d.). From the patients to the staff, the hospital has a diverse group of people who have different backgrounds. As a nurse and as a person, it is my responsibility to be culturally sensitive and acknowledge the different communities that I encounter. One example of a difficult situation where social awareness can be used is when there is a cultural or religious issue. When a patient passes away, hospitals can only give the family members a certain amount of time to be with the body at the bedside. Due to religious and cultural backgrounds, a family might ask to chant, be there longer than the allotted hours, or even have the patient clothed before passing. As an advanced professional nurse, I

5 would understand the complex needs from a religious and cultural perspective. According to Brou Fossier (2022), one of the benefits of social and emotional intelligence is having more compassion and empathy towards others. If there is no safety concern, I would advocate to respect the family’s wishes. Using Power Skills to Achieve Results By going through each of the five areas of social and emotional skills, I can utilize each section to help achieve professional presence, enhanced mindfulness, positive social presence, and joy in a healthcare work environment. Achieving Professional Presence Using Two Power Skills Professional and respectful behavior in the workplace is the essence of professional presence (Western Governors University, n.d.). When nurses and staff have integrity, effective communication, and are well-mannered, they can promote and inspire a healthy work environment that is seen by patients and other staff. As an advanced professional nurse, two power skills I would use are self-awareness and interpersonal communication. With self- awareness, I can recognize my strengths, beliefs, emotions, and thoughts that can influence my actions and, in turn, understand how those actions can affect another person. With interpersonal communication, I can build professional relationships with my patients and coworkers by actively listening, demonstrating care and compassion, and working in a team setting. By strengthening self-awareness and interpersonal communication in the workplace, I can achieve professional presence. Achieving Enhanced Mindfulness in Healthcare Using Two Power Skills Mindfulness is about giving awareness and attention to the present moment (Western Governors University, n.d.). Achieving enhanced mindfulness may take time to build, but in the end, it can help an advanced professional nurse learn how to react to stressors or difficult

6 situations. Two power skills I would use to enhance mindfulness are self-awareness and social awareness. One of the key points of being mindful is about being aware of the setting, situation, and those involved (e.g., patients, coworkers, etc.). In self-awareness, one must focus on recognizing such things and acknowledge what is going on in an open-minded way. This can then provide the foundation for how to act when situations arise because of these experiences. With social awareness, one must be cognizant of their social environment and how diverse it can be, including the workplace. One can then adapt and modify their actions and behaviors in a way that is productive for a healthy work environment. Achieving Positive Social Presence Using Two Power Skills Social presence is about “consciously supporting a social environment when communicating” (Western Governors University, n.d.). To achieve a positive social presence, effective communication is important. As an advanced professional nurse, the two power skills I would use to achieve this would be interpersonal communication and executive function. Interpersonal communication is all about building relationships and how we communicate with one another (verbal and nonverbal). Executive function is about adaptability and making decisions to reach a goal. By building relationships and adapting to the social environment with my peers and patients, positive social presence can be achieved. Achieving Culture of Joy Using Two Power Skills The first word that comes to mind when I think of joy is happy. To have a joyful culture would be to have a healthy work environment; a place where people enjoy coming to work. As an advanced professional nurse, I would also use interpersonal communication and executive function as my power skills. With interpersonal communication, I have the tools for effective communication. This helps build rapport with others giving the opportunity to establish a colleague or a work friend. For executive function, being able to critically think and come up

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7 with effective solutions is important when aiding my fellow nurses. Using interpersonal communication and executive function promotes camaraderie and teamwork, which also supports improving joy in the workplace (Perlo et al., 2017). Implementing Strategies from the IHI Framework for Improving Joy in Work Step 1: What Matters to Staff As an advanced professional nurse leader, I would implement IHI’s step 1 by having brief individual meetings with staff so there would not be any judgment from others and can provide a safe space if answers are more personal. One strategy I would use is to first let them know the purpose of the meeting and that we are looking to improve and/or maintain a healthy work environment. This can put someone at ease as one may think they are in this meeting to be reprimanded. Next, I would start by building rapport by asking questions about why they became a nurse and what brought them to their current specialty. Afterward, I would lean towards questions such as what makes them stay here, what matters to them by working in this setting, and what improvements may be needed. Throughout the meeting, I recommend using active listening and making note of key details. Step 2: Unique Impediments to Joy For step 2, I would implement this next identification during a staff meeting or a unit practice council meeting. All the staff should have already been spoken to on what matters to them to improve joy in the workplace. During the chosen meeting, I would set up a timeframe that is not too long, but not too short as we would like to get feedback from the staff. Part of my strategy includes informing on a couple of common points that stood out from the individual meetings. This shows the involvement of the team and the importance of improving joy can work towards a healthy work environment. Following that I would ask the team what gets in the way of having a good day at work or enjoying work as a whole. One step from IHI that I recommend

8 is to thank the person who just spoke and state that you want to hear from others on the team (Perlo et al., 2017). Depending on the timeframe, I would note down all the impediments identified and state when the next discussion would be. Step 3: Systems Approach with Shared Responsibility Implementing step 3 will require a set amount of time as it is best to work as a team to improve joy in the workplace. This can be done in another meeting setting where many of the team members are present. Part of the strategy here would be highlighting the good, and the bad, and that we, as a team, can work on making improvements. As a starting point, I would ask what improvement should be worked on first and so on. Once a list is established, we could then look at which ones can be done promptly, and which ones may take longer. Lastly, I would have them rank which improvement is more meaningful to them. This way we can prioritize an improvement and have an estimate on how long it may take. Step 4: Improvement Science to Test Approaches The final step will need to be done in multiple gatherings as this is when goals are made, and improvements are being implemented. The strategy in the first meeting would be to have staff choose which task they would like to be a part of. Once the smaller teams are made, discussions on what the measurable goals are for their assigned improvement. Each group can then work to start their improvements. I would also have them set a goal date and make sure that each group gets assessed periodically on their status. At the next meeting, I would celebrate and thank the teams for successful improvements. Those that were not successful can be re-evaluated and see what can be learned from their improvement process.

9 References Brou Fossier, K. (2022). Emotional Intelligence. Radiologic Technology, 93(4), 396–403. Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017. Wei H, Sewell KA, Woody G, Rose MA. The state of the science of nurse work environments in the United States: a systematic review. Int J Nurs Sci. 2018;5(3):287-300. Western Governors University (n.d.). Professional Presence and Influence. Acrobatiq. Retrieved September 5, 2023, from https://wgu-nx.acrobatiq.com/en-us/courseware/contents/wgu_D024_16Feb21_pro_presence_inf luence_1

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