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Nurse leaders Joanne Disch and Mary Beth Kingston share insights about how to overcome challenges and continue to push nurse leadership forward as a valuable voice in the healthcare industry.

Nurse leaders are no strangers to overcoming challenges. Drawing from their experiences, Joanne Disch, PhD, RN, FAAN, board chair for Advocate Aurora Health; and Mary Beth Kingston, PhD, RN, NEA-BC, executive vice president and chief nursing officer, Advocate Aurora Health Milwaukee, recently shared their experiences as nurse leaders about how they pushed forward during a session at the recent American Organization for Nursing Leadership (AONL)  2020 Virtual Conference.


The following are four ways Disch and Kingston say nurse leadership can be strengthened:


Disch says a chance encounter with a fellow nurse on a flight 20 years introduced her to the concept of professional generosity, a topic on which she has often written and spoken. Seated side-by-side, Disch and the other nurse spent hours exchanging advice about challenging situations they experienced. At the end of the flight, the other nurse thanked her for her professional generosity.

"[Professional generosity is] the idea that you freely give—whether it be expertise, resources, or your time—to a colleague.  And there's no quid pro quo; you just want to help somebody do their very best work," says Disch. 

On the other end of the spectrum, Disch also discussed her experiences with professional stinginess. "I worked with a few people who held resources too close to the chest, they didn't share information, they might not include me in workgroups that it would be appropriate that I was part of," Disch says. She adds, professional stinginess can extend further to faculty who may not share grants or publications, or make students wait for days before returning a marked paper.



While acknowledging that there have been many wonderful moments in her career, Disch says there have been disappointments, challenges, and setbacks she has faced that have actually helped her along the way. As an example, Disch recounts that when applying for graduate school she was rejected by several schools due to her grades. "In fact, one very prominent school sent me a letter saying, 'Don't even apply for graduate school. You'll never make it,' " says Disch.

But the University of Alabama at Birmingham gave Disch a chance and accepted her, she says. At the university, Disch would go on to be named "outstanding graduate student" and find a mentor in Dr. Marguerite Kinney , who would help usher her into critical care and connect her with the American Association of Critical-Care Nurses (AACN).

"My experience there was fabulous. I was so grateful that I had gone there, and I maybe wouldn't have if anybody else hadn't rejected me," Disch says.

As far as other challenges, Disch points to professional relationships that didn't start or end up the way she would have hoped but provided opportunities for her to learn about herself and about being a leader. For example, while serving as a chief nursing executive, Disch says her first meeting with a chief operating officer (COO) started with an aggressive anti-nurse joke and a dismissive attitude.

"We embarked upon probably a yearslong effort to get to know each other and for me to understand his story," Disch says. "I look back now and I think I was using my nursing assessment, my nursing diagnostic skills, to try to get at what was the story with this person."

Disch says after learning more about the COO's background and treatment by nurses in his past, she came to understand that he was insecure and intimidated by nurses. Once an understanding was achieved, the two developed what Disch says was an incredibly collaborative relationship.

Kingston says it is common to "go into avoidance mode" when encountering someone you feel doesn't care for you or you don't particularly care for. In these situations, Disch says she likes to step back and ask herself, "What is it about them that is really irritating me? What does it say about me? What can I learn? What's their story?"

By persisting with people with whom she felt diametrically opposed, Disch says she learned much about herself and would develop professionally generous relationships.

"Setbacks can become steppingstones," Disch says. "Not everything turns out happy, but I have been so fortunate to have colleagues across my career, who have stepped forward to give me advice, give me some resources and opportunities."



Disch, who has served as the president of AACN and the American Academy of Nursing and as chair of the National Board of Directors for AARP, says she has faced challenges while serving on nursing and non-nursing boards but the unique attributes nurses contribute are priceless.

"What we bring is a sort of understanding of the human condition. We know on the ground level what healthcare means, what it has to look like, what threats to safety and quality are, and we think about people in the context of their families. We are relationship-based/big picture, and yet can be very focused on the details of this particular patient and their family," Disch says.  

Having a nurse serve on a board changes the conversation and the focus, Kingston says. While everyone on the board is concerned about quality, they all may not necessarily understand what that means. Having a nurse present can help the board probe an issue rather than accepting everything at face value.

"A nurse will say, 'Can you dig a little bit deeper into that? And what about X? What about by Y? Going down a layer beneath the report is really valuable," Kingston says. 

Disch adds that even when a board has a physician on it, a nurse's perspective is still valuable. "Nurses know what happens at 2 a.m., which, on average, many physicians don't. So, physicians are great, they should be on the boards and also nurses, because of the perspective."



Nurse leaders are currently facing extraordinary circumstances as the country continues to deal with the ongoing COVID-19 pandemic.

"It's very hard being a leader today. At times in my career, I phrased it as taking people on a journey on which nobody wants to go," Disch says. So, during times of crisis, it's important to fall back on your relationships, she advises. When faced with issues and challenges, she suggests bringing together a team to brainstorm and ensure you get enough input to decide the best strategy, but to move expediently.   

Disch says it’s also important to think differently and challenge yourself to not rush back to the way you've always done things.

Kingston adds, "We all do come to those situations with our own biases and experiences and it's more comfortable to want to go back to the way it was. I think that right now is going to change the game, for sure."