EPISODE 11: REVOLUTIONIZING NURSING LEADERSHIP DEVELOPMENT

The pandemic has had many lasting effects, especially on patient care and vitality among health professionals worldwide. In this episode of LX Evolution, Michael Noble interviews Amy Trueblood, Senior Director of Leadership Development for the American Organization for Nursing Leadership (AONL), to explore the complex challenges faced by nurse managers and how effective leadership is crucial for improving patient care and organizational outcomes.

The discussion dives deeper into AONL’s mission, as well as how that mission has contributed to innovative programs that support nurse leaders in caring for themselves—and caring for others—as they navigate what it means to become a great leader during a time when they’re needed the most.

Top Takeaways

• AONL represents over 12,000 nurse leaders across various settings.
• The transition to nurse manager practice is a significant need in nursing.
• Nurse managers face complex challenges, including budget management and staff leadership.
• Effective leadership development is crucial for improving patient care.
• Programs must be accessible and evidence-based for busy nurse managers.
• Reflective learning enhances the application of leadership skills.
• Collaboration among leaders is essential for success.
• Data-driven outcomes are important for evaluating program effectiveness.
• Nursing leadership is evolving due to societal and economic pressures.
• Mentorship and support are vital for developing future leaders.

---

---

Michael Noble

Welcome to another episode of the LX Evolution. I’m Michael Noble, VP of AllenComm Advisory, and I’m your host for this episode. Our guest today is Amy Trueblood. We’re very excited to have Amy here with us.

Amy is the Senior Director of Leadership Development for the American Organization for Nursing Leadership. We’ll also call it AONL. And I’ll let Amy tell us more about that organization in just a moment.

I first met Amy earlier this year. We were working together on a Brandon Hall Group HCM Excellence Award for Best Association Professional Development Program. And of course, we were doing that because AllenComm has worked with AONL to develop a leadership development program for nurses who are making the transition into nurse leadership.

That program has won not only that Brandon Hall Award, but also a Davey Award. So we’re going to have a lot to talk about in our conversation today. Welcome, Amy.

Amy Trueblood

Thank you, Michael. It’s an honor to be here and so grateful for the invitation. Thanks for having me.

Michael Noble

Thank you very much. Well, first off, why don’t you tell us a little bit about the American Organization for Nursing Leadership, or AONL. Maybe you could also tell us a little bit about your own career and journey that took you to that organization?

Amy Trueblood

Sure, sure. So the American Organization for Nursing Leadership is really the professional association for nurse leaders. We represent over 12,000 nurse leaders across the country, and in fact, some international members as well. Our membership represents nursing leadership roles across any healthcare setting, or you can think of where patients are cared for and then also include those where patients are not necessarily directly cared for, such as academic settings.

We have advanced practice leaders as well as researchers, scientists, we’ve got nurse entrepreneurs. Our membership really represents a large scope of practice settings and rural settings, ambulatory clinics, hospitals, health systems. Really anything you can think of where a nurse may be, which is a lot more places than people know.

We have members that represent those areas and over 12,000 of them strong. Our mission is really to transform healthcare through elevated and influential nursing leadership. And so we fulfill that mission through our programming that we offer, through research, we have a professional practice arm where we focus on our competencies on our credentialing in terms of the certifications that we offer.

We’re constantly working with our members and our board to really elevate nursing leadership practice, the science of nursing leadership, and ensure that we are providing resources to support our members and for them to support their teams and the patient care in whatever setting it is that they work.

Michael Noble

Cool, fascinating. Let’s cover a little bit about kind of what took you to the organization.

Amy Trueblood

Sure, it’s kind of an interesting story for me anyway. I hope your listeners will find it interesting as well. I’ve been a nurse for 25 years. I’ve been in leadership for 20 years of that. And that’s somewhat rare. At the time, I was somewhat considered a younger leader coming in to nursing leadership, which is to say I wasn’t yet 30. Nowadays, that’s not so young. A lot of people are coming into nursing leadership practice at an earlier age than maybe historically, but I was a young leader and I had a tremendous mentor when I was getting my master’s degree in nursing administration.

We were in Chicago. I lived in Chicago at the time. And she invited me to, or actually said kind of, “you must attend this conference.” And at the time, AONL was called the American Organization of Nurse Executives. In 2019, they made a very strategic transition in name to better reflect and be inclusive of nurse leaders in all settings. That’s where we became and how we became AONL.

But my involvement with the organization started 20 years ago, which is another somewhat rare thing. I had the pleasure and honor of being a member of the very first class of the Nurse Manager Fellowship, which is one of our development offerings that AONL continues to offer to this day. I was a part of that first class and I served on committees. I really was welcomed into that organization as a leader, as a manager at the time.

Their CEO at the time, her name is Pam Thompson, was really interested in engaging managers and directors and others from across the country. And I just had the pleasure of being one of those that was able to be mentored by her. Over the years that I was able to participate, I became faculty for AONL probably 10 years ago in our various offerings for emerging leaders as well as nurse managers at the time.

So when this opportunity came up, I’ve served primarily in operational roles throughout my career as a manager, director. I was most recently a chief nursing officer and I left that role a year ago. And this opportunity came up with my predecessor in this role, Beverly Hancock was moving into a new role and she had been with AONL for about 12 years and been a dear friend and colleague over that time.

And so when the opportunity came up to really try to take and build upon the fabulous foundation and work that’s happened at AONL over the past, I just couldn’t pass it up. I have this opportunity to now serve in a different way of helping to create and strategically align programming that will help our leaders across the continuum really grow and develop in the competencies that they need to be effective and do their roles well, as well as help to serve their internal growth as human beings. That’s really important to me as well.

So a part that we want to make sure that we have included in all of our programs is how we are helping our leaders develop themselves along with the skills and competencies necessary to function effectively in their roles.

Michael Noble

Well, I think it’s really interesting just how influential the organization has kind of been, at least as a context over most of your career. And I know that from speaking with you and your colleagues, there’s a lot of passion around helping nurses and helping nurse leaders.

Our podcast is about change in learning strategy and the changes that learners face. I’d love to hear a little bit about what you think that, you know, the needs of nursing leaders are, and from the organization’s perspective, I know you guys do research and that kind of thing, but what would you say are the kind of big needs that nursing leaders have that the organization is trying to meet?

Amy Trueblood

Sure, so one of our challenges—and it’s also just a tremendous opportunity—is what I mentioned previously about the variety of roles and settings in which our members practice and trying to meet all of those needs, and needs of all of our members, and be inclusive of those that want to develop leadership competency regardless of title or role or setting in which they practice. That’s one. That’s one thing that is just a unique opportunity for us, I believe, at AONL is to try to serve such a vast and diverse group of individuals.

As it relates to some of the more, I won’t prioritize any of them because they’re equally as important gaps that need to be filled in developmental needs for leaders across the continuum, across the spectrum, as I mentioned regardless of role or title.

What we do know right now, a lot of your listeners are probably aware of the issues and complexities that are happening within nursing as a profession right now related to roles, related to supply resource, having enough people, the salaries, maybe even understanding the impact that nurses have on quality care that’s provided in all settings and in how they’re leading that work.

Our roles that we focus on for our members, really in this particular case in the program that we’re going to discuss in detail today, is our transition to nurse manager practice role. So that takes a subset of our memberships and that program is intended to fill a very significant need. And if I could, I’d love to just share a little bit in case your listeners are not aware of a typical structure or what the role of a nurse manager is.

Typically, any group of people, if you can imagine, and we’ll take the hospital setting, they’ll please understand nurse managers exist outside of the hospitals. But the hospital is easier for people, I think, to relate to or picture in their minds.

If you’ve ever been a patient or had a family member who’s a patient in the hospital, in all likelihood, if they need to spend any sort of night, overnights there, they end up in a department within the hospital, potentially with some sort of specialty, let’s say cardiac. And that department may have, we’ll just use some things here, may have 25 to 30 rooms and patients at any given time. Then they have nursing staff that are assigned and allocated out to make sure that the patient’s needs are met.

Every one of those departments has somebody that covers in a what we call a 24-7 role—that is the nurse manager. Typically, nurses must report to a nurse. So a nurse manager must be a registered nurse minimally, and depending on circumstances and location, they’ll have a varying level of experience prior to taking on the role of a leader.

The nurse manager role is extraordinarily complex enough that AONL has worked to develop not only our core competencies, which would apply to all leaders in all settings that are nurses, but the nurse manager-specific competencies we have. It’s one way that we’ve been able to outline, “here’s exactly what competencies one should possess, areas that they need to work towards and grow in their development in order to successfully navigate this nurse manager role.”

Those competencies are for nurse managers in any setting, just to say that again, just to be clear. And that’s because nurse managers—a lot of people don’t realize this. Here’s folks that come out, you’re managing not only from a financial perspective, multimillion dollars in budgets. If you think about salaries, and patient stays in hospitals, and medication costs, and supplies, and all of those types of things that go into that. Those managers need to manage that budget, make sure that they are allocating funds appropriately, that type of thing. And that’s more of a kind of tactical type of responsibility that they have.

They’re also responsible for ensuring that their teams are practicing within regulatory standards, that their performance is managed, and most importantly, that their patients are having an experience of high quality, that their outcomes are positive from a clinical perspective. And they do all of this. There’s so much more. They’re responsible for the culture of the work environment and all of those things that you would expect out of a manager.

And they do all of this in an area that is accessible to anybody, right? It’s accessible to the public. It’s accessible to any other person in the hospital that needs to come up. And these managers are often put into these roles. Historically, it’s one of these things that we’ve just always known, but more recently paid a little bit more attention to.

We’ve been put into these roles without any actual developmental content, educational programming to help guide them through that switch from if they presumably had experience taking direct care of patients for some time. Now they’ve stepped into this manager role and oftentimes do so without that appropriate development to help them build those competencies that they need to function.

Oftentimes managers have more than one of those departments that I just described. There’s a lot of information and research. A1L is a part of this with some of our partners as well. A lot of research right now on the span of control where you think about these managers each. I believe the median was somewhere around 45 people that report to them directly. And that could be RNs, could be nursing assistants, a variety of roles that can report into each of these managers.

And sometimes on the upper end, upper quartile, I believe of that, we’re looking at the 80-100 direct reports. These managers, their performance, their effectiveness—this is aside from just creating a role that is fulfilling to a human being, right, and allowing for work-life balance. They’re responsible for their departments, which function 24/7.

And so you can imagine the complexity, just the, always call people in these roles, those courageous leaders working in the middle because you’ve got organizational priorities that are coming from one end. You’ve got the need to humanly care for your staff. You’ve got complexities around workplace violence and all these other really, really tragic issues that are occurring in healthcare settings right now. And this one person is typically responsible for managing all of that and often goes underdeveloped or underresourced in order to do that. That was a long story.

Michael Noble

But it’s really telling. Because it’s like, I think the challenges that our listeners would recognize about leadership development are exponentially more complex in this area of nursing. So like, for example, even that change that you talked about at the very beginning about going from kind of an executive leadership focus to a kind of first level frontline leadership focus is something that, yeah, many organizations are dealing with that. But all of the kind of societal and economic pressure that has been put on the nursing profession has created this kind of perfect storm of stress and responsibility and everything else with that role.

And I think what it does is it takes us to this question of, okay, you’ve got maybe one of the busiest and most overwhelmed learners you might have. How do you design a program for someone like this who can’t take a break for two weeks and go to a workshop?

Amy Trueblood

Exactly, exactly right. I believe that while this was peripherally a part of AONL as faculty when the decision was made to develop this transition to practice on-demand program, which we did in partnership with AllenComm.

That was exactly, what I can only presume, that was exactly what the thought was, is that here’s what happens in those organizations. Then beyond the manager, there’s a director generally, there’s then with divisional authority, and then there’s a chief nursing officer potentially, you know, and most of the time that’s how the structure works. And we generally have professional development departments and educators and that type of thing.

But what ends up happening is that organizations try themselves to develop or put together some content. Let’s gather all the managers. Either we put the nurse managers with other managers, which is perfectly fine, but neglects the unique aspects of nursing leadership science and what I was talking about, about very few people in a hospital, professional groups, very few have this.

But what happens for nurse managers is they’re responsible for everything that happens in a geographic space. It’s not just personnel leadership. It’s not only performance management. It’s somebody from, you know, a therapy department comes up and is walking with a patient, for example, and the patient falls. It’s that nurse manager that needs to be responsible for all of the follow-up, and the management, and culturally, how do we make sure everything is in line to keep patients safe and also do the appropriate follow-ups there?

So there’s a unique aspect to development of nurse managers in specific that is oftentimes neglected when we put them together with everybody else. Not to say there’s not benefits to that, because there certainly are from a cohort learning perspective.

My presumption is that Beverly and the team at AONL at the time were really identifying, rightfully so, that a program that is easily accessible, that is evidence-based, that allows for some self-paced learning would be really beneficial to really exponentially grow the number of managers that can be impacted and developed with a program that meets those criteria, that includes all the things they need to develop their competencies. And it’s accessible, easily accessible to them.

There’s also a component in this program of a growth planner which allows for what we know to be really, really important reflection time, reflective learning, and offers an opportunity for these managers to meet with their one-up or others throughout to make sure that they are actually taking in all of this learning. And so somebody can help them know, “hey, here’s how you connect the dots, right? You just learned about human resources management. Now you need to hire 10 people. What can you take from that module and those lessons that you got from that evidence and bring it into your real life?”

It’s really helpful to have a mentor or somebody, and this program encourages that as well for the participants in the on-demand program. And we offer the content with the on-demand in cohort facilitated learning as well, which is to me, it’s really the cream of the crop, the ultimate way to help to engage our leaders and get them this content that they need so desperately.

Michael Noble

I love how you described the application of the content, because I think a lot of leadership content, yeah, we get inspired by vision and communication and the principles of leadership. You brought us to reality with, “they own a particular space, and anything that goes wrong in that space, they have to be able to troubleshoot.”

And I just was impressed myself looking at the materials of how very practical this is, right, and you get your audience is each in a different context. And so those tools have to be Pretty clever to prompt learners to say, “this is what you look for in order to be able to make this your own.” And so think the program does an excellent job of that.

I know the program’s been out for a little bit. I know you guys have been measuring and looking at results. What can you tell us about maybe the difference that the program’s making?

Amy Trueblood

You know, I have really been, in the last eight months or so since I’ve been in this role, I have just really been blown away by what we can see. As we know, when we’re leading learning, oftentimes there’s different levels of outcome that we can look at to assess the effectiveness of our programs and our learning activities. And so for these, we do a couple of things to try to get a little bit higher level in terms of understanding what level of outcome we’ve achieved.

So we do include for our on-demand program a pre-assessment of the competencies, of the nurse manager competencies, and a post-assessment of those for select learners as they go through this program. When we do a facilitated cohort with an organization, which we call a hosted cohort, which includes the on-demand, and then we train faculty within those organizations to lead their own cohort, we also include pre-self-efficacy assessment and a post-self-efficacy assessment.

We have just tremendous outcomes showing an elevation of each of those, the assessment of the core competency as well as self-efficacy, sometimes to really, really high levels. And in particular, I think what people really love about the on-demand is that the modules, they can go back to them. They can be real time. So they might kind of go quickly through everything or they might take their time. It doesn’t matter. But then one day they go, “I’m doing my budget right now. You know what? I’m going to access that module and know that I at least have the resources to help me engage there.”

So at that level of outcome that we can really look at, we’re seeing really great indications that this program is of extraordinary value, both from a competency development as well as a self-efficacy perspective.

I am very excited to partner as we do more of these hosted cohorts with partner organizations. I’m really excited to look with those organizations at their cohorts for outcomes that even get to like a level four and level five outcome in terms of how are people who have had the benefit of this program actually performing? How are their departments actually performing? Have they increased their retention of nurses? Are their quality outcomes better? And various things that we can work out with the organizations to try to get to that higher level outcome as well.

Because we know we have the only fully put together, evidenced-based on-demand program for these leaders transitioning into their first manager role. And we know that provides such extraordinary value. What that translates to then for our organizations, and for like who cares kind of thing, is when managers are effective, based on everything I mentioned before to give the context and the complexity of that role, those are all the outcomes that are enhanced when our managers are developed and are functioning at a high level through the development of these competencies.

So it’s better patient care, it’s better work environments for our nurses to hopefully in any setting bring our nurses, have them be interested in working there and staying there and developing themselves as leaders. Our purpose is to transform health and elevate healthcare. That’s the outcome.

It’s just when you’re talking about managers, they work through others, right? It’s their leadership that helps create these environments and cultures that provide the patients the environments that they need that are compassionate and focused on the quality of care that’s being received. Those are the ultimate outcomes that I would love to see as we partner more with using our on-demand program with our hosted cohorts to really get into those higher level outcomes as well.

So we can just demonstrate it and show for sure we love data, we nurses love data. And to show this program is just that effective and maybe even more so than I think.

Michael Noble

You know, for us, it’s refreshing just because so often there’s not good data. And when data is so much a part of your culture and being evidence-based in everything that you guys do, I think that’s fantastic to hear about that and fantastic to hear about the practical use of the data. We’re not just gathering it. We’re using it to make decisions about our program and where we’re going to go in the future.

Yeah, we’re getting towards the end of our time. I’d love to end on a question that’s a little personal, kind of about your own experience as a leader. As you reflect on, you know, this fantastic career you’ve had and the opportunities that you’ve had as a leader, and you think about change, what kind of advice would you give your younger self when she’s moving into a leadership role in terms of lessons learned or, you know, hindsight’s 20-20? Yeah. What do you want to leave us with?

Amy Trueblood

You know, I guess one of the primary lessons that I’ve learned in time, and certainly in transition to this role, and this is—our partnership is a great example—is you don’t need to be the expert in everything. And there is an army, there are teams of people, are experts that collaboration and partnership in all areas. I used to think if I asked, if I didn’t know it, then somebody was going to think I wasn’t a good leader or whatnot. And I’ve found the more that I share what I don’t know, the better people think I am as a leader, which is so opposite to what I grew up kind of thinking about, I suppose, managers or that type of thing.

So what I’ve really realized in all facets of life really, but certainly professionally is that, I’m just one voice and there are so many others. And asking the right questions, listening, you know, strategic partnerships. Like you mentioned earlier, we wouldn’t even know where to go if we weren’t connected with our members. That’s number one, connecting and understanding what do they need? What are the gaps? What do they think of what we’re doing now? What is the level of outcome that we can demonstrate from various things?

Continuing to ask, being vulnerable to let people know when you don’t know, and finding those partners that are going to cheer you on regardless of the length of time or what happens. People that can connect with your purpose and really help you to deliver on what it is that you say that you’re interested in doing to fulfill your mission, whatever that looks like.

In our case, it looks like a partnership that develops an exceptional program that fills a significant gap for our members, and that’s something to be very, very proud of, and I’m so grateful to be a part of that journey.

Michael Noble

Wow. Well, a lot of wisdom there and congratulations to the organization, to AONL, for the recognition for this program. I’m excited about what’s next. And I love the fact that your organization is already talking about what’s next, because it’s really what we learn from rolling it out that’s really going to make the program better. So. Thank you.

Amy Trueblood

Absolutely, and we’re so grateful for you and your team as well, and we just will continue learning together along the way.

Michael Noble

Appreciate that. Thank you, Amy. I hope you’ll join us again when we roll out the next cool version of your program. And listeners, thank you for tuning in. And please tell your friends about us and drop us a line at info@allencomm.com if you have ideas or questions.

And just a reminder that we’re on all of the regular podcast distribution channels and also on YouTube. So check us out. Thank you, Amy.

Amy Trueblood

Thanks, Michael.

---

The Learner Experience Evolution is a weekly podcast for L&D learning leaders to stay inspired and gain valuable insights from other industry leaders.

Subscribe now to never miss an episode wherever you listen to your podcasts.