Thursday, April 12, 2007

Co-Creative Leadership

In the third oral history interview conducted last year, OHSU Emeritus Professor Barbara Gaines sat down with outgoing School of Nursing Dean and OHSU Vice President Kathleen Potempa to talk about Potempa's tenure at OHSU and her views on nursing education and leadership. A particularly interesting section of the interview concerns Potempa's work with the Oregon Nursing Leadership Council and the resulting development of the Oregon Consortium for Nursing Education. Her comments certainly reach beyond nursing and are, I think, applicable to many problems in our modern world:

GAINES: ... You know, one piece from the—you wrote a fascinating article in Nursing Administration Quarterly looking at your experience through this process in terms of how to move folks out of their own houses, as you say. And you talk a bit about our kind of parochial view of leadership within nursing. And some other comments that you’ve made that I found fascinating would look at how, in fact—or perhaps this is correct, how in fact the OCNE program and the work that you all did as groups who sort of came siloed to the meetings initially, and have moved, have helped us deal with the issue of the entry question. Which just buries this country as far as nursing practice. And I wonder if you’d say just a bit more for us about your experience and what it’s done to your philosophy of leadership. Or what it’s meant to your philosophy of leadership. Or vice versa.

POTEMPA: Well, it was, the article was really based on some theories of group relations. So it came from that theoretical framework. And it really comes from the notion of co-creation of ideas and co-development of ideas. And one of the things that happens when you come to things from a siloed perspective is everyone is absolutely convinced that their view of the world is the correct one. And that if you compromise, it lessens the effectiveness of your capacity, the effectiveness of your opinions. And getting past that, and reducing the barriers and the boundaries between the groups, so that they can be open to hearing the potential of the other view, is part of the leadership process that led us to being able to see the world a little differently. And in that process, redefine the situation. I think part of the definition was what evoked the kinds of strong, passionate, opposing views, simply because the words kept people in an old place, in an entrenched place. And so we learned through listening to one other to completely redefine a situation in a way that opened up the boundaries, and opened up the lines of communication.

But wayfaring through that initially, we had to learn what the words really meant. Like “entry into practice.” And it was deeply entrenched and had deep and layered meanings. And so we had to get to all of that.

And then, through that process of focusing in on ourselves, we were able to realize in almost a short minute that it isn’t about us at all. And that by staying in that view, and by being in that way that we were, we weren’t achieving, none of us—baccalaureate, associate’s degree—were meeting our mission, really. Because we were focusing in on the wrong things. So we said, we have to think about this differently. And to do it, we have to do it from the ground up. As a process of co-inquiry. In other words, all of us would take a ground-up exploration, being completely open to the conclusions that we would draw from that exploration. And that’s when we began the process of looking at the data. This was about the people we served. It wasn’t about our entrenched view of how we came to be nurses and who was better. We came to the conclusion that none of us were doing it the way the future required of us.

But getting through those barriers was part of the initial work, and the parochialism that comes from a siloed perspective. And it’s really a metaphor for, or a microcosm, if you will, of what can happen in healthcare, when various professional groups come from only their entrenched view. Such as physicians. I don’t want to cast them into a stereotype. But if a physician, for example, believes that the most important thing is the differential diagnosis, that’s very different than the view that nurses hold, and it’s very different than the view the patient holds. And to get past all that, in terms of what’s driving healthcare, you have to open up the boundaries and the communication. And all of us have to remember that it’s the patient’s view that we have to remember as well. So it’s a similar process that can be carried to different situations.

No comments: