Composing growth: Reflection through narrative

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As a nurse manager in a contemporary healthcare setting, you have enormous responsibility to sustain quality, safety, innovation, efficiency, and financial performance at the unit level, while ensuring that your team is prepared and capable of delivering the required patient care. You impact care at the point of service and, through your leadership, can influence practices that promote or compromise patient safety.1,2 Expert nursing leadership is essential to achieving national patient safety agenda goals.1,3 Medical errors, falls, near-misses, and sentinel events continue to increase, and are often attributed to leadership failures.1
As a nurse manager, you also directly impact hospital reimbursement; the financial penalties for not achieving quality outcomes are high.1,3,4 In addition, of course, you're responsible for managing a unit budget and making sound fiscal decisions; poor outcomes and low levels of nurse staffing are associated with increased hospital costs.1-3,5-10
As a result of these challenges, your role has become broader and more complex. Translating the vision and goals of the hospital and the nursing department into reality hinges on your expert practice.3,11 Your role success requires a mastery of leadership skills to inspire staff to embrace change, as well as systematically evaluating patient care practices.3,11
Traditionally, nurses learn to assume a frontline leadership position through didactic education or on-the-job training, but that's fallen short of preparing them.3,12,13 The complexities of contemporary healthcare demand new leadership development approaches to achieve major organizational goals.3,5,12-15 Ensuring highly effective nurse manager practice has rightfully become the focus of nurse executives, researchers, and organizational executives.3
Nurse managers can utilize the pedagogy of reflection through narrative writing to acquire the knowledge, skills, judgment, and ethics to cope with the increasing demands of this evolving role. We provide an overview of an educational project demonstrating the importance of reflection through narrative writing and how to implement the technique in ongoing nurse manager leadership development programs.
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