Leadership in Cardiovascular Nursing

Welcome to Heart to Heart Nurses, brought to you by the Preventive Cardiovascular Nurses Association. PCNA's mission is to promote nurses as leaders in cardiovascular disease prevention and management. 

Geralyn Warfield (host): We were so excited to be able to spend time today with Sandi Dunbar, Sandi, I'm going to go ahead and let you introduce yourself. 

Sandi Dunbar (guest): I'm Sandi Dunbar and I currently am the [Charles Howard] Candler Professor at the Emory School of Nursing in Atlanta, Georgia, at Emory University, and I'm very excited to be here today. I've been in nursing for quite a while and have seen many changes—and some of them have been very positive. And it's very exciting to think about where we are as we chart our path for the future of nursing. 

Geralyn Warfield (host): So, Sandi, you [00:01:00] have an abundance of experience in cardiovascular nursing, and you have seen a lot of changes over time. And as we've discussed offline, there are a lot of ways that nurses can find out information about leadership. It might be through books or podcasts like this, or people at their workplace. Where would you point a cardiovascular nurse, perhaps one who's new to their career, where would you point them in terms of great resources for leadership information?  

Sandi Dunbar (guest): Yeah, that's a great question because I think there are a number of, you know, books and things that people can read. Certainly, there are, there are numerous seminars and leadership workshops that people can attend. Frequently, institutions may have a leadership mentorship program, and a leadership ladder within their own organization.  

And I can, I know, in [00:02:00] our organization at Emory University, we have things that faculty can go to for leadership development. We have, in the clinical setting, there's a whole leadership ladder and leadership development, that goes from, you know, the new leader to the emerging leader, to they experienced leader. And I think leadership is something that you never stop developing. You can't just say, “Oh yeah, I know how to do this.” It's constantly evolving in a person, based on the context, the situation, the individuals that they're working with and, clearly, the mission of what they're trying to accomplish. You know, I think about professional organizations in nursing have a lot to offer too, in terms of leadership, and PCNA is developing some great resources for its [00:03:00] members, and, and allies. So, those are some, some resources. 

Geralyn Warfield (host): So, one of the things that you just described was a mentor program. And I wonder if you have any experiences that you would like to share then, in terms of being a mentor, or needing a mentor and looking to find one in your career, and how that process was for you.  

Sandi Dunbar (guest): So, mentorship, I think is really key to the retention of, of nurses in the healthcare system and also the development of their own, of their career—and people can rarely do this on their own. It's, it's great to have someone to help point the way, you know, I, I like to use the analogy of, you know, somebody who's going to climb Machu Picchu, or maybe they're going to climb Mt. Kilimanjaro or something.  

They never go without a guide. 

There's always a guide who helps point the [00:04:00] way or helps point out barriers and possible solutions to overcome, who helps them prepare, and have a plan. And so, some of the key things that I think have been successful in mentorship is helping people plot out a plan of what, you know, establish what are their goals, what are their long-range goals, and vision for themselves, and what are their short-range goals? Short-range, meaning, you know, within the next year or so. 

And then how are they going to get there? You know, what are the steps that they need to take? And sometimes getting really detailed with that development plan. And it's not something that you really think about doing much for yourself unless someone guides you and helps you develop that kind of plan. 

I think a mentor is someone who can help keep you accountable, right? So, if you set out a plan and you're meeting with your mentor regularly, it's a time to review your progress. It's not a time to, to really wallow in, a fact that something wasn't accomplished, but to also think about why and what, what can be done.  

So, those are just some of the things I think that are important is, being in a mentor-mentee relationship, being able to give and receive feedback, and for mentors and mentees to figure out how they're going to work together. Are they going to work together by meeting frequently? Are they going to perhaps work side-by-side on something, where someone might, you know, provide additional expertise? And [00:06:00] the other thing that's really key is to think about the difference between mentorship and sponsorship. And so, you know, mentors tend to help guide someone, and sponsors, I think, open the door. You know, they're the ones who help you get nominated for something or help someone else see your potential. And sometimes it's not the same person. Sometimes the mentor can be the day-to-day or the, you know, not day-to-day but the guide; and the sponsor is the one who actually can connect you with an influential person or something like that. 

So mentoring is, I think, a key part of leadership and really helping to inspire, inspire the thinking about others and, and to guide others. And it's really an important piece that nursing needs to develop more of.  

Geralyn Warfield (host): So, as we're talking about [00:07:00] developing nurses, I believe you have an opportunity in your role to work with individuals who are just starting on their career. Did I get that right?  

Sandi Dunbar (guest): That’s right. 

Geralyn Warfield (host): So, I know that you've seen some changes in the nursing profession, in your career, and even in the last two to five years, particularly the last two, of course, we've had the COVID pandemic impacting what we do in terms of nurse training and things like that. I'm sure that there are some barriers that you could describe, but what are the opportunities that you see for nurses that are entering the career now, that may be the same as what happened when you entered your career or might be markedly different.  

Sandi Dunbar (guest):  I think nurses have a lot of opportunity, that that's much more diverse today. I mean, at one time there were, there were limited sort of career paths for nurses, but now, I see so many other opportunities. And there's opportunities for nurses to be engaged in patient care, advanced care, prevention, to be [00:08:00] engaged in leadership and management. And also not just management and leadership within nursing, but stepping out and being in other aspects of, of the provision of health care as leaders—owning their own businesses. 

We've seen exciting things that nurses do for the, for setting up wellness programs or, you know, even, inventing things and developing their own companies, that provide a type of device or a type of innovation. That's, that's something that I don't think we thought about, you know, 30 years ago or whatever, you know, you might see, well, there's a real need for someone to develop this, but, nurses were not really encouraged to be inventors or makers of, of new things. And now, now we see some of that.  

[00:09:00] In addition, I think there's opportunities with technology, to improve access to care through things like telehealth, and other ways that, that help nurses—that help people have access to nurses, from communities where there, there may not be…we have nurses very engaged now in things like telemonitoring, and remote monitoring of physiological and mental health, physiological parameters, as well as mental health, and providing care based on that type of assessment. So, those are just some of the ways. 

And I think nurses can be, you know, in clinical and academic settings and industry, and a whole variety of things. There's also global health [00:10:00] opportunities and, the world is just at their feet.  

Geralyn Warfield (host): We are talking with Sandi Dunbar about nursing leadership and the future of nursing. We'll be right back.  

Geralyn Warfield (host):  And we're back talking with Sandi Dunbar about nursing leadership and the future of nursing. We've had some discussions with some other professionals in this podcast series talking about global issues and how nursing across the globe is not the same. So, a practitioner here in the United States might be a little bit different in terms of their scope of work than somebody elsewhere in the country or elsewhere on the globe. And that PCNA is looking to provide information and educational resources to help level the playing field, I guess I would say, and provide opportunities for those global nurses. Can you talk a little bit about PCNA’s role in the global sphere?  

Sandi Dunbar (guest):  Well, I think PCNA has a huge opportunity, to not only contribute to sharing of resources and [00:11:00] information, but to also learn from other institutions, other global leaders, and how things are done differently in different healthcare models, looking at ways to improve upon what we're trying to accomplish. Through not only sharing of information, but sharing of ways to lead and, and engage their, their members from these international organizations. 

I think that PCNA has provided the opportunity through the Global Nursing Leadership Forum [GCNLF] to, you know, share information and share opportunities like that.  

Geralyn Warfield (host):  So, as we look ahead to what might be next for nursing, I know that you have an interest in a report called The Future of Nursing. Could you just tell us about that?  

Sandi Dunbar (guest):  [00:12:00] Okay. So, The Future of Nursing report is a document that was created by the National Academy of Medicine, and a panel of experts in nursing and healthcare. And they looked at the health and well-being of the nation and the role of nurses and how nursing could contribute in much more depth across a variety of settings and a variety of actions—through increasing nursing's capacity, increasing nursing's expertise, and increasing nursing's engagement in health care.  

And some of the exciting things that came out of that report, which is really to address the years of 2020 to 2030, include several priorities to help [00:13:00] strengthen nursing overall, such that it could be a more, a stronger, contributor to healthcare. And so, some of those things include things like acting now to improve the health and well-being of the nation, and finding ways to engage nurses, and things like improving care coordination. We know that healthcare can be quite disjointed.  

And, and we also can see that if we think about this from PCNA’s perspective to just really focus in on PCNA’s mission and how can we tailor some of our strategic priorities to this report. So, if we're talking about care coordination, how can we improve preventive care and coordination of preventive care? 

And what are the strategies that PCNA can engage in to facilitate capacity in that way? One thing that we've talked [00:14:00] about is expanding the distribution of the cardiovascular certificate program, which is part of the goal of increasing expertise, which fits well with this program. 

There are some other strategies, for example, lifting barriers to, to the contribution of nursing. 

One thing, for example, is that we know that 27 states do not have a full practice authority for their advanced practice nurses. And thus, there's a real need for advocacy to, to change laws such that nurses can practice at the top of their preparation, and the top of their license, and finding ways to reduce those, those barriers. 

That would improve access to nursing as well as some of the things we mentioned before, [00:15:00] expanding telehealth, and retaining the increased scope of practices that were, that were levied during the pandemic, that proved to be very beneficial to patients. We know that we need to design better payment models for cardiovascular nurses and for cardiovascular care. 

And all of these are efforts to improve health equity as well as…that's the overall goal for strengthening nursing, such that we can play a better role in advancing health equity. If we think about the priority of strengthening nursing education, we know that we need to increase the diversity of nursing in general, and definitely of cardiovascular nursing, so that our nurses reflect more of the types of populations that they serve. Strengthening nursing education, and increasing the diversity of the pipeline of [00:16:00] nurses, is key for this as well as, you know, PCNA has talked about taking the certificate program into a nursing education programs as well.  

Another priority is valuing community and public health nursing, and this is key as we think about prevention and addressing broader populations. And this would be important for PCNA. We've looked at the idea of developing partnerships with such groups as the American Public Health Nurses Association, and school nurses, and thinking of ways that we might provide resources for prevention for those groups.  

Fostering nurses’ roles as leaders and advocates is another key priority. Again, working to increase our members’ opportunities for leadership development, [00:17:00] as well as increasing the diversity of, of PCNA’s membership, and engagement, and leadership.  

And, certainly, preparing nurses to respond to disasters is key for cardiovascular care as well. And, there's many creative strategies that we can identify to improve nurses' ability to prepare for pandemics and other disasters, as well as to prepare our cardiovascular patients.  

And then, finally, supporting the health and wellbeing of nurses is really key at this time. And looking at ways to improve the, both of the physical and mental health of nurses, through, through a variety of individual and institutional strategies.  

So those are some of the things that I think are a high priority at this time.  

Geralyn Warfield (host):  So, it sounds like the future of nursing is very [00:18:00] bright and it's very varied in terms of what people might be doing in their jobs, both today and well into the future. I've been talking with Sandi Dunbar, and we are so grateful to her for sharing her time with us. 

I'm Geralyn Warfield, your host, and we will see you next time. 

Thank you for listening to Heart to Heart Nurses. We invite you to visit pcna.net for clinical resources, continuing education, and much more.