Competency That Supports Nurses with Donna Wright

When we talk about competency in nursing, it is often framed as something to complete or check off. But what if competency could truly support nurses, strengthen confidence, and build engagement over time?

In this episode of Beyond Nurse Residency, host Nicole Weathers is joined by nationally recognized competency expert Donna Wright, MS, RN, NPD-BC. Drawing on decades of experience, Donna invites us to reconsider what competency really means in nursing practice and professional development.

Together, they explore how traditional, task-focused approaches can create fear, frustration, and disengagement, especially for new nurses and high performers. Donna shares a more thoughtful, human-centered approach that emphasizes ownership, empowerment, accountability, and trust. The conversation highlights how organizations can move away from overwhelming checklists and toward systems that reflect real practice and support learning over time.

This episode is especially helpful for nurse leaders, educators, and NPD practitioners looking for practical ways to simplify competency processes while fostering confidence and purpose across the nursing workforce.

GUEST: Donna Wright, MS, RN, NPD-BC
Donna Wright, MS, RN, NPD-BC, is a nurse and professional development specialist and consultant with Creative Health Care Management in Minneapolis, Minnesota. She holds degrees in Nursing, Family Sociology, and Adult Education, all from the University of Minnesota.

Over her career, Donna has worked with healthcare organizations across the country and around the world to design meaningful, effective programs that support professional development and competency assessment across all departments. She is the author of The Ultimate Guide to Competency Assessment in Healthcare, which has been translated into Japanese and is used widely throughout Japan. She is also the author of The Competency Assessment Field Guide.

Donna is a co-author of two national award–winning books, Relationship-Based Care: A Model for Transforming Practice and Advancing Relationship-Based Cultures.

Her work has taken her across six of the seven continents, including rural Africa. Antarctica remains the only continent she has not yet worked on.

Throughout her career, Donna has served in both staff and leadership roles and is well known for her energy, curiosity, and refreshing approach to education and learning. She is a member and past president of the Association for Nursing Professional Development and a recipient of both the “Promoting Excellence in Consultation” award and the Marlene Kramer Lifetime Achievement Award.

Website Links:  Creative Health Care Management  | CHCM Competency   CHCM LinkedIn | CHCM Facebook | CHCM Instagram

Articles or Publications: Durkin, G. (2019). “Implementation and Evaluation of Wright’s Competency Model.” Journal for Nurses in Professional Development. Vol 35, no. 6, p 305-316.

Wright, D. (2021). The Ultimate Guide to Competency Assessment in Healthcare. 4rd Edition. Minneapolis, MN: Creative Health Care Management.

Wright, D. (2020). The Wright Model of Competency Assessment: 5-part video Series. Minneapolis, MN: Creative Health Care Management.

Wright, D. (2015). Competency Assessment Field Guide. A Real World Guide for Implementation and Application. Minneapolis, MN: Creative Health Care Management.

Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp  to explore our resources for new graduate nurses and beyond. 

Transcript

Host Nicole Weathers 0:01

You're listening to the Beyond Nurse Residency Podcast, an educational series where we interview experts on all topics related to the transition of new graduate nurses into practice and beyond. I'm your host, Nicole Weathers, Director of the Iowa Online Nurse Residency Program. Thanks for joining us. Let's jump in. I've been thinking back to a time early in my career when I was training to a new specialty area, obstetrics. I did everything I was supposed to, right? I went to the classes, I attended the conferences, I checked all the boxes on my competency checklist, spent hours working with a preceptor. And then, like many of us, there was that day where I became sort of on my own, working independently. And here's the truth: like, even though I had all this preparation, I didn't really feel competent. I could recite the material, I knew the steps, but in the real world, with real patience, with real pressure, I just never really felt like I had mastery. I tried very uncomfortably for a while. And then eventually I realized this just wasn't for me. I wasn't meant to be a labor and delivery OB nurse. So, you know, really looking back at that experience has led me to think more about competency and that it's not just sort of this clinical requirement, but there's a lot more to it. And so today we're going to be shifting our conversation into this idea of competency, what it means, why it matters, what it influences beyond maybe the obvious, and how leaders can maybe simplify that competency process in a way that helps nurses thrive instead of overwhelm them. And to explore all of this today, I'm joined by Donna Wright, someone whose work has shaped the way many organizations kind of think about competency. So welcome, Donna. I'm so excited to have you here with us today. Thank you, Nicole. Great to be here. Love to talk about competency anytime. Well, and I don't even think you know this, uh, but I learned about your work very early on. So I was an educator at a small rural hospital. I was charged with onboarding orientation. I was trying to figure out the competency thing and I bought the Ultimate Guide To Competency Assessment. And I had great thoughts and ideas of like, this is what I think we need. This is so great. Um, unfortunately, at the time I ran into some roadblocks with getting uh the other people in my organization on board. So maybe we'll talk a lot about that today as well. But I've actually been following your work for a really long time. Um, and again, even though we haven't maybe formally met, I'm so excited that you're you're here and you're joining us for this conversation. So why don't we start off by having you introduce yourself to the rest of our audience?

Donna Wright 2:54

Okay, well, thanks, Nicole, and I'm glad I'm here joining you in this discussion. Um, my name is Donna Wright. I guess I would call myself the competency lady. I'll give myself my own title, but I'm uh actually officially a consultant with Creative Health Care Management, which is an international consulting firm that does all kinds of things, helping people prepare for Magnet or uh developing their leaders or looking at their competency processes and programs or looking at relationship-based care. We do all kinds of different things. So um, that's the group that I'm a part of. And however, I have been studying competency assessment for three decades. It is a passion of mine, um, kind of a sick career choice, but I love it. So um, so I've been um speaking, writing, reading, talking about competency most uh most of my professional career and uh happy to be able to spread that through different means. So I've written several books, I do a lot of different presentations and conferences. So yeah, anytime I can talk about it, I want to do that.

What Competency Really Means

Host Nicole Weathers 3:52

Excellent. Well, and it sounds like you're more than the competency lady. It sounds like you're the competency queen if you've been doing this for not long. Okay, I don't know. I don't have a scepter, but awesome. Well, uh again, really excited to dive into this conversation around competency. Um, and before we do, or kind of to to start us off, I think it's always good to just make sure we're we're all talking about the same thing. So kind of level the playing field, you know, do some groundwork here. So when we talk about competency and nursing, you know, what does that really mean? Why don't we just start there?

Donna Wright 4:31

Okay. Sure. Yeah, I think a couple different things. First of all, it it's much more complex than we realize. And we talk about we want to make sure that people are competent. Well, what does that mean? Well, I say there's many different um levels or phases that we we assess this at. So um, I mean, I'm a nurse, you're a nurse, we and this could be for any professional group at all. But you first start off by um preparing yourself in um your profession, which is the professional preparation, going to college, and then passing an exam and getting licensed or certified or registered. So everybody does that kind of thing. Um, that's the first level of competence. Then the second level is really where you're coming into an organization and the question is how do you then express that licensure registration or certification in our area, our organization? And that's where people right away kind of get messed up on things. Sometimes people want to redo the exams we took, like the NCLEX exam. We're not here to recheck that, but then there's always the question, well, what if they didn't know how to do that? Or, you know, so there's this apprehension, and that's why we still have to kind of watch that. But we have so much stuff in our orientation checklists, so to speak, that get into checking off the basic head-to-toe assessment again. Really? No. So what you're really trying to do is that if you're getting a job in an organization in the middle of rural Wyoming, or you're going to work in downtown Manhattan, New York, these are different places and you need to express your talents in different ways. Are you going to be working in an independent clinic where you're the only nurse or other professional available? Or are you going to be part of a large team that's doing different things together and you're sharing the work? So it is about expression of your skill set into a specific location. And that's where I think we mess up. We right away slide right back into are they just a competent nurse who left college or competent professional, it could be a pharmacist or a physical therapist or whatever. And then we're checking that off again. And that doesn't serve us well. And like you said, it didn't help you fit in to what you needed to do in that clinical area that you didn't feel comfortable in.

Host Nicole Weathers 6:42

Why do you think that is? Like, why do you think we slip into that? Well, we're just gonna check the box and we're gonna check them off things that we they should already know. Why, why do we go back down that path?

Donna Wright 6:53

Okay, um, we could do a whole eight-hour workshop on this one. I'll tell you in brief. It it comes down to some trust issues, it comes into all kinds of different levels of trust. Uh, and this could be even beyond just the orientation. Let's also get into the ongoing competency stuff as well, too. But it's like, how do I know that they're like this? And as an executive, how can I see that? How do I know as a preceptor that they're gonna be good at this? Or as an educator, you know, um, how do I trust that the the nursing school they went to covered that or the other preparation area that they went to made sure that they had that experience? So I have to say it's not about like you're not a trustyworthy person, but our systems aren't really built to build that trust. And I've worked really hard to figure out ways we can do that so we can trust people. And that actually loops right back to engagement. If you want to talk about engagement today, that is one of the best things where when we have that systematic trust, the trusting kind of things in the system, then you start to eliminate some other problems as well. So we'll just keep circling back around to that in this conversation today, that it's trust and it's not trust in a way you always think that they're not a trustworthy person. So it's different than that.

Host Nicole Weathers 8:05

You know, and I sometimes wonder too. Um, so I could totally see it being trust. I also see, you know, checking the box as sort of the comfortable or I mean, no offense to anybody who does this, but kind of the easy way out. Yep.

Donna Wright 8:21

And that leads to a second component too. There's a fear-driven component that enters into competency. I have a I have fear of the regulatory bodies not approving us. I have fear of being sued as an organization. I have fear that someone's gonna accuse us of not preparing people well enough. And then we have a situation with a union or something like that. So we have a lot of trust issues, a lot of fear-driven things. These are really across the board for a lot of other things in your in any organization that stop us from being truly successful and truly engaged and truly leveraging the talents of everybody. Uh, these are some just core principles that um yeah, boil down to the culture in which we create within our organizations.

Host Nicole Weathers 9:03

So, as much as I am all about like, what do we need to learn about competency to make this better? I think sometimes the question too, we need to kind of approach it a little bit different. But like, are there things leaders, NPD, need to unlearn about competency in order to effectively move forward?

Set Minimums Then Build Pathways

Donna Wright 9:22

Yeah, I think, well, actually, the word you just used is the word learn. Um, I think some people right away think competency is all about education or it's about learning, which is actually the second step. Don't get me wrong, it's right then there, but it's not the first step. Actually, when we think about stuff around competency, it's more about um what do we need to uh be able to have or do in our job or as an organization? And do we have the people to be able to do that? For example, one time I um, well, I saw this beautiful definition one time of competency. Actually, I think it was in the one of the joint commission manuals years ago. It was great. And it said, uh, competency is all about requirement equals capacity. And what they described was what you're required to do or what your organization says they're gonna do, what's your requirement? Do you have the people or the capacity to fulfill on that promise? So let's say you say we're gonna be a level three trauma center in our organization. Do you have the people who know what a level three trauma center looks like or can do the skill in that category? If you say you're gonna be a PEDS-friendly environment in your hospital, your organization, do you know what the components are or can you express PEDS-friendly environment in your practice? And so that to me starts to change everything where it's not about me, the individual, learning something. It's about me saying, I'm in this organization. And if we've now been designated as a stroke center, do we have the people who have the capacity to deliver on that, to do what we say we're gonna do for the public? So it it just changes the entire thing. It's more about what's required in the job. And now this is what's exciting as leaders. That's really articulation of expectations. We haven't even got to competency yet. That's what do we expect of you in your role?

Host Nicole Weathers 11:09

That's a really interesting way to, I think, look at it because I think another thing that we sometimes see, especially with new graduate nurses, is you know, this new nurse is brought in to fill a role that maybe a 40-year nursing veteran has exited. And we expect them to be at the same level.

Donna Wright 11:32

Yep. And that's true for just about everything we do, whether it be, and this is where I'll say I put uh competency in different categories. So, you know, you want to be able to do things that determine should someone even come into your organization to be hired. And then what do you do during initial competencies, which is the orientation plus getting them grounded into the experience they're gonna be doing? So it's more than orientation. That's why I use the term initial competency assessment. And then after that, the ongoing competency assessment has to be a part of it. And actually, that's the strongest factor that cements the DNA of your organization. I love when people say, I've been here for 20 years. Don't you know I'm competent by now? And I say, if you're still functioning like you did 20 years ago, you ain't competent. You gotta, you know, you have to constantly keep evolving. It's that commitment to I'm always gonna strive and move forward with my organization. And that's the the partnership we have. Um, and it's not about now I'm competent. No one ever is truly competent. It's always a it's a dynamic process. So that that continuum, that flow, that commitment to moving in the direction where where we've designated we're gonna go, then it's a collaboration after that of the employee and the organization moving together.

Host Nicole Weathers 12:46

So this may be a simple silly question. I don't know. Um, but do you think about competency as like a one size, you know, fits all? Like all of my nurses on my unit are being held to the same level of competency or requirements.

Donna Wright 13:03

Yes and no. I'm gonna say is that one size fits all. I believe the expectation is the same. How we're going to express it can be different. So, um, first of all, and and it doesn't mean that we're all at the same level. I want to be clear on that. But competency needs to describe um the minimum expectation you need in an area. For example, if I'm in the ICU, the minimum expectation we have for responding in a code is ACLS. You know, that's pretty high. That might be on Banner's model, way up to proficient as far as skills go. But everyone in the ICU needs to be at ACLS or higher. You know, some people have passed the, you know, the ACLS requirements. Some people are teaching it in the ICU, you know, so you can have that level or higher. It's okay. Um, or where another clinical area might be BLS and that or higher. So you have to describe the minimum expectation that everybody in the job category needs to have. So minimally you need to be here. And then you even define it as people come into the organization. I'm not expecting them to function like that 40-year nurse that you talked about or a professional. Um, but I expect them to be able to get up to this minimum expectation so they can take this basic assignment or do this project or do this work, whatever we're asking them in that role. So competency is about you need to be here or or higher. Then how you can verify that, that's where it gets creative. Oh my gosh. That's the part where we can individualize it and allow for different different um personality types, learning styles, engagement things. So during the initial competency period, I tend to give um fewer options just because um most people coming in are not looking for a lot of freedom yet. They want to just tell me what I need to do and they're focused. And that we just need to know that. That's where people are then. But I usually like to have an option that would be good for a new grad and someone who's seasoned. So I almost always like to have two options. Don't make a seasoned person go through everything that the new person, you know, like, I know this, I've been an oncology nurse for years. Can I just take a test to prove? I know, or can I show you my certification in oncology, you know, or whatever. So you have to have like maybe two paths for initial uh for verification, but or or two or more. And for the ongoing, I like to give, you know, two, three, four, sometimes even five choices where people could bring different things that say, uh, prove that you know how to do this, or you can you can take care of this type of patient, uh, this new ventilator patient we have. And maybe we have different verification methods that can be done on different shifts and with different personality styles to it, or things that could be caught during a QI monitor, that you already got caught doing it correctly because you're doing it all the time and you're engaged with it all the time. Um, or some other people do a case study because they don't know where to even begin and they can read about it and do the case study or the module. So um yeah, this it's kind of all the same for the competency, but the verification or the verification is where you start to get creative and have options.

Host Nicole Weathers 16:04

I wrote down the you this um word realistic. So I like that you because I mean that is something that we've talked a lot about um with a lot of our partner organizations, is we need to just make sure we have realistic expectations for each unique sort of individual that's coming into the organization or each sort of level. So new grad expectations, while we still hold them to the same minimum, um, we just need to be realistic in those expectations for them. Yep.

Donna Wright 16:36

Yeah, and I think that's where, especially during orientation, I lean into the tiered orientation process. There's a lot of different tiered models out there, but in general, what tiered says is that you kind of are on a path somewhere and you designate within that tier, um, and and just so if people have never heard of the term tiered orientation, it's kind of like saying first you need to crawl, then you need to walk, then you need to run. That's kind of the basic way I describe it. So in orientation, uh, you're describing for people the, you know, the whole process you go through, but you might graduate from orientation, so to speak. I just use that term, to say with just the the the walking part. You we don't expect you to run yet. I want you to not only know it, but can apply it at least once. Or I need you to be able to do the whole thing because you're in charge and it has to go all the way up to the running phase. So you're each competency can have different expectations, but you're defining that. And then that puts a map for later too. So I'll go back to the ICU and you need to be able to complete ACLS and prove that you can function in a code. But in a year and a half from now, we expect you to be a code leader and do the debriefings. You see how I just took a new grad and helped define the path they're gonna take in the ICU. They're gonna get to a higher level, but not during orientation. Just function at a code, please. That's what we want to give you good at.

Host Nicole Weathers 17:58

Right. And I think that's a mistake maybe a lot of organizations make is that they're not always realistic in their expectations for new grads as they come in. They're they're seeing that, you know, a nurse is a nurse is a nurse, um, regardless. And so uh, you know, I guess just as you're kind of talking about that, that's something that's kind of like percolating in my brain here about how this might be an area where we need to begin to really work with organizations to kind of rethink um how they do this.

Donna Wright 18:28

Yeah. And our systems, our systems don't necessarily support it very well either. So I think sometimes it's not just uh let's change some competencies, it's let's we need to change some of our systems too that support it. Because I think educators feel panicked that I have to get everything into orientation. Well, no, that again is not realistic, exactly what you said there. Um, or how can we do this so that we have this pathway or plan or uh you're creating a portfolio for yourself? And and yeah, there's all kinds of different ways you can do this to make it better. And actually, these things end up saving money and time in the end too. So this isn't, I don't know. We just have to rethink how we do our systematic processes.

Host Nicole Weathers 19:10

Because I remember being a you know educator in a hospital, and you know, we want to get this orientation checklist done by the end of your preceptor time, right? Um, and totally not realistic, especially in a rural hospital where we might see a chest tube once a year. Like it's not gonna happen in the you know, six to eight weeks or whatever we were giving them at the time uh to get that done. And so um I like this idea of it doesn't all have to be covered in the beginning, like again, figuring out what that minimum is, kind of working towards that standard, but then giving them space to grow. So uh I think that's just a great way to kind of look at competency.

Make Orientation More Than Tasks

Donna Wright 19:48

And I don't know if we are always so good at even articulating what we expect, even for ourselves. You know, um, you know, we hear all the time hit the ground running after orientation. I want them to hit the ground running. What does that look like? And um, you know, we need to be clearer about that so we can help them understand. We expect you to look like this at this point and then like that later on. And we miss completely miss certain things that they desperately need. Like during orientation, people need to feel like they belong to the group. And we sometimes they get a connection with a preceptor. We hope sometimes it doesn't happen, but but the whole group and and building trust with the whole group. We need to help them with just even how to do days and nights and nights and evenings and how to, you know, manage home life and hear and park your car somewhere. I mean, we tell them stuff, but we don't always help them truly manage that and embed that into who they are. Um, some of our well-being stuff and and professional uh parameters of wellness around what we do and how to do that every day. There's so many things that I am now redoing in orientation. So we're moving from that checklist of head-to-toe assessment to something that's much more professional driven. And I want to see the verification that the employee has back more of professional curiosity, of understanding how to engage in communication with somebody outside your department. Um, get a hold of a doctor that's hard to get a hold of, things like that. You know, the things that we know are really the secrets of the job.

Host Nicole Weathers 21:23

Well, and I think that's something that, you know, is always kind of a topic of conversation around residency and new grads is we have the clinical sort of hands-on technical skills, and then it's like everything else. And it seems like people are much more concerned with the hands-on clinical type skills than the everything else. And so I guess what's your thinking around that? Are these competence or are some of these competencies more important than others? Do we, you know, look at these competencies differently? Maybe you can talk a little bit about that.

Donna Wright 22:00

Yeah, I think where we're at right now is we often divide up our our roles, however we define it, into uh a list of tasks. And we've all felt that way for a long time. And we check off all these tasks. It could be protocols or procedures people have to do, or we look at their charting, or we have them take a test of knowledge, things like that. And I feel like sometimes an orientation, it's like we're telling the new person um, we're going to give you a new car for orientation, and it's here in these boxes, and you have to put it together yourself. So the parts are all there. Don't get me wrong. Somewhere in these boxes is a Lamborghini, but you got to put it together yourself. And this is where I hear so many times people say, you know, they'll ask the team, how's that new person doing? And the team will respond, well, they were checked off for everything, but they still don't really get their job. So what are we missing in that? And I think we haven't made it um, we've taken the test and we haven't made it comprehensive. Um, so I'll give you an example that I think can actually uh deal with some of the trust issues and the fear issues, the belonging, the all that kind of stuff and the skill set at the same time that we need to check off. So um I've got several groups now that are saying during orientation, you get like a list of five or seven essences of the job. Like you find the job in this area, kind of these are the essences of who we are, you know. And so we say, while you're caring for a patient with your pre-educator andor preceptors as you're going along, you need to um at some point along the way uh contact a doctor, get a hold of them, and have them call you back and maybe change an order or something like that. You have to set up some communication with another department. You have to discuss some things with the family or do some teaching with the family or look at something with the family. You need to adjust the care plan. You know, these are different things, not all with the same patient, but with different people along the way. And then you put together kind of a case presentation with these five to seven different components that you have. And you can use one patient or two patients in your case study if you have to, you know, go to more than one to get your story that you're gonna put together or your couple stories. And then at the end of orientation, once your preceptor says, okay, we've checked everything off on your list, I think you're ready to present your story to the team. So then you go back to like a staff meeting or something where the whole team is there, and you say, you know, the preceptor says, I'd like to introduce, you know, or a new person. Many of you have worked with this new person, but they're just about ready to finish orientation. And why don't you share your case study? And then they go, okay, here's where I called me, you know, Dr. So-and-so, and blah, blah, blah. And I helped with this, and then I have to adjust that. And I did that to help the family. And here's my presentation. And people like, wow, awesome work. You able to get a hold of that doctor. He's so hard to get a hold of. And you set up a thing with physical therapy. Good for you. So I, as a staff person, now start to see you as someone who I met maybe, you know, a month or so ago, two months ago. And now I see, wow, look at the progress you've made. I feel much more welcoming to bring you into our team and I feel comfortable with you. You have shown how you can put the whole picture together and do the entire kind of job, and you're bragging it up. And your preceptor's right there to make sure that you don't falter. And I think that starts to put everything together. And what if we got rid of the checklist? We just used that as a tour guide, and we said, you have to have your team endorsed that you're ready to go. And right there it would change everything.

Host Nicole Weathers 25:40

Wow. That is a very interesting, I think, approach to this. It sounds, I mean, it sounds really, I mean, it makes a whole lot of sense, right? That that is kind of, I mean, that's the ultimate goal. That's what that's the outcome that we're really after is to have nurses that are working on our units that can do those sorts of things. But we segment everything out and we break everything down and we do everything sort of in isolation. And I think that, you know, thinking back to the example I gave at the introduction to this episode of like I was able to do all of these things, I could recite this information. It it was harder for me to put all of these OB skills um, you know, together. And I it it makes me just wonder if we had taken a different approach, you know, would that outcome have been different?

Donna Wright 26:32

Yeah. Yeah. And I think, and along the way too, I think it helps people to see if they're in the right specialty because maybe you weren't, maybe you were, I don't know. But also to say, you know, in that OB position where you, you know, did you see the complexity of like family dynamics and GYN, OBGYN is complicated sometimes and that some people thrive on that? How to help that, you know, bring that new person into the world, but in a situation that is not always easy. You know, and I see that how could we help people embrace that in a different way? I just think what I just described to you was a lot of changing systems, but it doesn't take a lot of radical stuff to do that. It just takes some purposeful action to say, are we ready to move from a checklist that has not served us well over the years? And we we know that, to something that that, I mean, maybe even ticks off more of the boxes of a broader scope, a more comprehensive way to look at our role than just the skills or protocols or procedures we have to do.

Competency In A Fast Changing World

Host Nicole Weathers 27:36

So this might be pretty obvious, but you know, so much of I know so much of our discussions in our um nursing professional development groups at the national level, at ANPD, there's so much discussion around competency beyond sort of the regulatory aspect of competency. Why is this such an important topic for us?

Donna Wright 28:04

Well, I think um twofold. One is bare back again to the trust and things to make sure that we have the people. Because to be honest with you, when it comes to being sued or dinged by some survey group, they hold the organization accountable. So the organization just goes right into it. You know, even in a lawsuit, very rarely does a professional get sued. It's more, unless it's a doctor, but it's more the organization. And the whole key to the lawsuit is did you make sure that they were competent? You know, that's really the what the lawyers are going after. So it isn't, you know, must watch the individual, it's the organization that they have systems in place for that. So that that's one part of it. And then the other part is that the world is changing just so fast. I will tell you that, and this is more than just post-pandemic, but you know, the half-life of information from the 1980s to now, in just 40 years, has just exponentially grown. From 1980s, it was about two years that the half-life of information, the year 2000, it was right around 12 hours. And now we're in the decade of the 2020s. We're talking nanoseconds. And so this ongoing, always, you know, I have to always be more and more current and know more things. And, you know, within a just in moments, it's changes. I mean, everybody that's listening here has probably had a protocol last year that came out at the beginning of the year. Then a month later it was tweaked and changed, and now we're gonna do this. Oh, but now you can't dispose of that like that. So three weeks later, a new thing on how you dispose of the stuff that the IV things that you pull down, and then you have to label it like this. There have been like five changes in a protocol all in one year. So are you competent? Well, you know, where are you competent? If I ask somebody, are you competently doing it? Well, yeah, no, you're not because you didn't dispose of it correctly. You didn't document it right. This has changed, that has changed. So, right there, we're in a different world. So I think that's why it's so important now we get good at it. Yeah.

Host Nicole Weathers 29:56

Do you think that contributes to some of like the burnout and things that we see in our nursing workforce is kind of this half-life of information and the constant change and the constant need to, you know, look at competency.

Donna Wright 30:11

It could be. I I could be, but I I think for me, I and this is just my opinion, but I think it's helping people find the passion of their work. You know, I I really want people to there's a reason I I want to have curiosity with this. There's a reason people went into the profession that they did, you know, and frankly, I bet you and I probably have this as well, too. Didn't you have some things that you imagine in your head you'd do as a nurse? You know, that I thought um I would sit with a dying patient holding their hand. What was not part of that picture was somebody screaming from the hallway, hey, Dr. So-and-so is online four. You want to come and talk to them? You know, it's like just a minute, you know, like I to find those passions and then help people get those moments in the reality-based world we live in. I know that sometimes that wasn't always realistic, but I have now found as a nurse some of the things that are the most difficult to do are the things that bring me the most joy. You know, it's having that crucial conversation with a coworker and really finding common ground and finding out we have a lot more in common than we have differences. Oh my gosh, I can work with that and that's awesome. Using therapeutic relationship within our teams. Oh, I love that kind of stuff, you know. So I don't know. I think it's not so much the I think I don't want to get into you gotta work smarter, not harder, like we just gotta go faster. I think it's different because I don't think people get into healthcare because they knew it was gonna be easy. They got in because it was gonna be a challenge, but let's find the joy in the challenge or the passion. And that's what keeps my fire going. I don't know. How do you feel about that, Nicole? I mean, do you is that where'd you get your passion? Because you've been in this a long time too.

Host Nicole Weathers 31:56

So yeah, I mean, I think um well, I my next follow-up question to that was gonna be like, how does competency factor into helping you find that passion? Does it?

Finding Fit Through Strengths

Donna Wright 32:08

Yeah. Okay, yeah, probably. Well, and I think too, I think even helping people find the right specialty. You know, I think when you come out of a your preparation school, your professional preparation, you don't know what you, you know, you want to do. You might think you do. I mean, I have so many people, I want to work in PEDs, and I go, Are you sure? Because that's hard. Labor and delivery, right? Like everybody it's hard, you know? Yeah, you f have your first stillbirth, and oh my gosh, this is a difficult place to be. So um, I just say, and I will tell you, my um my specialty that I found was my true love. I did not know it even existed in nursing school. And I'm a head and neck cancer nurse with laringectomies and trachs. And if someone along the way, a preceptor and educator, didn't help me understand that um my ability to, well, move into some surgical services with ARIMA management and things like that, if they didn't help lift that up for me, I would have never thought head and neck cancer is my love. Um, it's utums and trach. Who wants that? Oh, but I thrived in that specialty. So I'm grateful. And maybe we have to have systems that not only allow the person to know what they want, but the preceptors and educators to have things in place that help support um, you know, matching the person with the right situation.

Host Nicole Weathers 33:37

Um yeah, I mean, because I would say, you know, I initially thought I wanted to be a science teacher. Uh, I love sort of, you know, biology and some of those things. Uh I ended up down the nursing path and, you know, anytime like patient education. And then I was introduced to this world of nursing professional development. And I was like, oh wow, I didn't even know that this was an avenue that my career could could really go down. So um, yeah, I do think a lot of the things that you're exposed to, and then even, you know, when you first start in a profession like let's say, you know, education, practice-based education, uh, you know, you're kind of interested in it at first, and then you find out, like, oh, there are a whole set of, you know, competencies and practice models and all of these things that help me do my job uh better. And then with that, I think, you know, passion kind of continues to to develop and you continue to grow down this space. So I could see, you know, it's obviously a combination of a lot of different things, but it does feel a little bit like competency in an area, you know, does play a factor there for sure.

Donna Wright 34:50

Yeah, and I I can just share my own personal journey that uh early in my nursing career, I thought I wanted to work in the operating room, which I did try. I will tell you it was not a good fit for me, but I didn't realize, I mean, here's where I started. I thought, oh, I love surgical stuff. This is gonna be great. But I what I didn't plan on in the operating room, especially in the scrub position, you're next to the doctor, you can't move around, you got the mask over your face. And some of people know who I am. I'm very expressive with my whole body and my face and everything. I'm a very outgoing person. I would bump the table, I would hit and then they would complain about, oh, she's too fidgety and all that. Finally, my manager and the lead preceptor sat me down and they said, you know, this isn't probably the place for you because here's this, you know, they told me pretty, gave me some good feedback, and I was so devastated. Oh my God, I'm not a good nurse. They said, Oh my gosh, no, you're great. Circulator, you're moving around, work in the room, and you have high energy. We know where you should go. And they recommended to me um that I should go to PACU because I know all the surgical procedures and I'd be great to wake up the patients. Woo-hoo! You know, you need Donna to be in your recovery room, which then led me to airway management, which then led me to head and cancer. So you see how, and I'm not saying we have to be a career counselor for people, but I am so grateful that people early in my career saw what worked for my personality and what didn't. And it got me into the right place. Um, and I don't know even how they did it back then. I wish I kind of could see, did they map out, you know, is she a safe enough nurse, but surgery is just not her place. I don't know. So I'm trying to, you know, bring that to life in professional development of how can I help people be able to look at that?

Host Nicole Weathers 36:36

Well, I love the strength, sort of that strength-based approach, right? It wasn't like here's where your weaknesses are and we have to fix those, but instead let's look at, you know, what strengths you bring to the table and how we can really use those to help you down that path towards, you know, what you might find passionate.

Donna Wright 36:54

That's a great way to put it. Yeah, that strength assessment versus uh uh, you know, gap analysis of where you're falling short.

Host Nicole Weathers 37:01

Because we could have spent all the time in the world trying to get you to to be the person we wanted you to be in in surgery, right? But instead, we helped you find kind of where you could go.

Donna Wright 37:11

Yeah, exactly. You're right. And I don't think I would have loved it there. I mean, I go there now and I I look at it and I say, yeah, that's not my personality at all. But that's okay. You know, it fits for other people.

Engagement Through Ownership And Choice

Host Nicole Weathers 37:22

That's fine. Yeah, for sure. So this this year we've been talking a lot about sort of nurse engagement and the things that influence nurse engagement. And so I'm just curious if you see any sort of connection between competency and ensuring our staff have competency, you know, in these, you know, certain areas, depending on our specialty, and the level at which they become sort of engaged in their work.

Donna Wright 37:47

Um, well, first of all, I'm gonna say this from a couple of different points where engagement really shines. I'm gonna actually start with the ongoing competency process where once you're in an organization, when you can start to be part of the assessment of what do we need for our comp to be uh to be successful in our job, if our job is expecting us to do this, what competencies do we need where we actually get to um own our practice, our service, and our competencies, it starts to change everything. I see a direct link. People are reporting time and time again when we made um the we had this the team be able to identify their own competencies as a group with their manager and their educator. I'm not saying they do it on their own. We come together and say, what's happening in our cardiac unit or our behavioral health area, whatever. And you say, This is really what we need in order to achieve the goals that our organization has set for us. So it's a beautiful gap analysis that we can then pick our own competencies. Uh, shared governance gets stronger, uh, staff satisfaction goes up, patient outcomes get better, and you have a longer retention of people, the people you want to keep. Those are all things that just excite me. You know, so you want to have people engaged in that so they can own their practice, their work, and their service, um, and therefore their competencies. So that's that's a part of it. Um, and so that that's one aspect of it. The other part is when we're looking at engagement, giving people choices and options with their verification means everything. And if you can make the competency verification methods matter and the competencies matter, then people just start to shine. Um, I can share another example. I was um recently in an OR, and I mean, this is now for my consulting job. I was working with an OR team, and we were uh gonna go into the surgery area and they were gonna show me some different things. So I'm changing into scrubs and I'm with another nurse that I've known for years. And we she opened up her locker and I saw in her locker um a verification method. It was actually an exemplar, a story that she had done a reflective thing on, and it was three years old. I recognized the form and I said, you know, you have that form still. And she said, Oh yeah. I said, you know, you don't have to keep it. We've uploaded that in the computer. You know, you've been checked off for your competency. You don't have to keep it anymore. And she said, I will never throw it away. She said, that exemplar that I did was one of the best things I uh the best moments of my professional career. It was a difficult day where I had to stand the ground and be an advocate for the patient in the operating room. And I reflected on that moment and I wrote my story down. It is like a thank you note I wrote to myself. I went, oh my gosh, you know, when somebody is keeping a competency verification method as a souvenir. Oh my gosh. But she was so proud of herself in a moment where no one really saw her do that, but she got credit for it through the competency process. I just love stuff like that.

Host Nicole Weathers 40:44

Well, and we're terrible about taking the, I mean, it, you know, we're working our shifts, we're getting to the next patient, we're rushing, rushing, rushing. Rarely do we take the time as nurses to sit down and probably reflect on some of those things.

Donna Wright 40:58

Yeah. And imagine if we had a competency that said, you know, um, you know, something about being an advocate in a different difficult moment or dealing with a difficult situation with a professional colleague or whatever the competency is. This is where we can get into some competencies other than skill, like uh the kind of technical skills. We're getting into critical thinking or interpersonal skills and stuff like that. And she chose to do a reflective story on that, which then her peers reviewed and all of that. So it was truly competency verification, but it was something that after it was all done, she kept it. And I go, wow, that's absolutely what we want to do. We have to have competencies that matter, where people say, This is why I got into this profession. This is why I do what I do every day.

Host Nicole Weathers 41:44

And I think sometimes when it doesn't feel like it matters, like when it feels like we're just checking the box, nurses are less likely to probably I don't want to use the term engage over and over again, but they're less likely to really put time and effort into it because they feel like it doesn't matter.

Donna Wright 42:03

Well, and we can use the word disengage or being disenfranchised. Here's a very common thing that happens in almost every organization I go to. Somewhere we have, you know, we got a problem with something like, oh, we have a problem with CADY, you know, catheter-associated urinary tract infections or something like that. 80% of our clinical areas are having a problem with it. We're gonna make a mandatory competency this year on CADI. Everyone has to do the module and test. So we do this. We this is what's called spray and pray. We spray it on everybody and pray that it's gonna improve outcome. So now imagine if you and your team are not part of the 80%, you're part of the 20%. You guys have been working hard to bring your CADI rates down for two years. We've had zero CAUDIS. And now you got to do the module and test on CADI. You start to say, why do we even bother? Doesn't anybody see how great we are in the work we've done? So you don't you don't just keep that group average, you actually suck some life out of them. And that's the sad part about the approaches we take with competency is that we've actually kind of not increased engagement, not even increased competence. We kind of made people say, who cares anymore? Just do what you're told. That's a sad place to be.

Host Nicole Weathers 43:20

So what I hear you saying is not only is maybe competency, you know, important for engagement, but how how we are validating competency is going to be important for engagement as well. Absolutely.

Donna Wright 43:33

And I think too, it's about um allowing allowing the competency to take place where it needs to take place. Um, there's so many where again we spray and pray it on everybody and it just doesn't work. And we're creating beautiful mediocre organizations. I've never seen anybody yet put a banner in the lobby that says shooting for mediocracy. No, we're shooting for excellence. So your team that was doing great with our Ces was striving for excellence and was achieving. It. And now what do we do? Oh, who cares anymore? You've just dropped that engaged person down to mediocre in your efforts to bring up the people below the line and bringing them up to the level of where they need to be for safety. We we tend to not do well with those. I want to lift up our low performers and I want to lift up our high performers at the same time. And that takes a talent and that takes a different kind of system thinking. Uh, leaders have to think in a different way. Educators and managers have to think in a different way. Absolutely.

Host Nicole Weathers 44:34

Oh, do I have an amen? We'll go with an amen. I I I'm like sitting here, they can't see me, but I'm shaking my head. Like, you're pre you're preaching to the choir here for sure. I mean, there's nothing worse in any aspect of life than you know, getting the email that says, we have a problem, everybody needs to fix this, blah, blah, blah. And you're like, are they talking to me? Because I think I'm doing that right. But like, I mean, it makes you start to question sort of everything, sort of that, you know, we're just gonna put this blanket thing out there and make everybody do it because it's just easier to have everybody do it than to really focus on where the problems are.

The Spray And Pray Trap

Donna Wright 45:11

And then you feel invisible. And why would you want to be in a place where you feel invisible? So that's where the engagement comes right back around. If you feel seen, if you feel like you belong somewhere, you're more likely to contribute to that. It's a it's then that family of who we are. You know, it's it's back to what Brene Brown talks about in almost every one of her books, you know, is that belonging principle. So if we say when we look at competency or engagement and all that, you got to feel like you belong as part of a team. That when you say, this hospital, this organization is mine, I influence it every day and I'm proud of it. That to me is the essence of engagement. Not up above told me I've got to do this, this, and this. That's just an employee, then. I don't want that. Yeah.

Host Nicole Weathers 45:56

Well, and I think, you know, I guess I before this conversation, maybe I didn't understand the importance of it's not just, you know, the what, but it's the how and how how we validate competence, how we approach people on, you know, building their, you know, professional identity or their professional practice. How we do that is even more important to growing engagement.

Donna Wright 46:24

And actually, I think all day long, this is the the, I shouldn't say the humorous part of my job, but it entertains me every day. I go into organizations and we tell people two opposite messages all the time and in different categories. For example, we tell them, we want you to be a critical thinker, but yet we'll tell you what to do and how we're gonna be checking you off. You know, I think, well, that's kind of opposite. Or my favorite one is uh it's all about the patient. It's all it's patient-centered care, it's all about the patient. And then they'll say, Oh my goodness, the surveyors are here today. Quickly, everyone over here. Well, I'm with a patient. Leave them, leave them. I mean, it's like, uh what do you want from me? And I just sometimes I think we are telling people two different things, or our words say one thing and our actions say another. So frankly, a lot of what I think is related to competency has to do with how we as leaders, formal or informal, that could be managers, educators, everybody, how we come together to understand exactly what you're talking about here. Do we know what we're actually trying to accomplish here? This isn't just completing a list and checking people off.

Host Nicole Weathers 47:32

Yes, absolutely. So let's talk about that then. So let's say we're in an organization where the we might be telling them two messages, leaders, educators, they're they're trying to maybe take a different approach to competency. Where do you even begin? How do you begin to simplify this process? How do you begin to just look at this differently? What advice do you have?

Donna Wright 47:59

Well, if if anybody's ever cracked open any of my books, there's there's three words that seem to pop up all the time. They should for you um ownership, empowerment, and accountability. Those are the three words I keep. That's part of my model, everything. It's always there. So I want to then look at what are our systems that allow people to own their care, their work, their service, and their competencies. So we have to look at that. Um, and having the educator pick your competencies is not achieving that goal. They can help you facilitate that process, but not do it for you. How can we empower people? Where we have the employee at the center of the verification, and how can we empower them with choices and options so they have control over things? And then how can we create an accountability-based culture, uh, which is really about what we say we're gonna do, we do. So I usually have some discussion with leaders, even. Are we expecting everybody in this organization to be competent? And people say, Well, of course. Okay, then let's look at all of our actions to see if we really are doing uh, let's look at our own report card on that. And sometimes when you look at here's a scary one, but uh I've seen managers who write a disciplinary note. I'll just use this one a disciplinary note that says, I'm gonna follow up in a month. What percentage of managers actually follow up at the end of that month? And most organizations, that's 20 to 25% of the time. So I'm not saying it all comes down to disciplinary action, but if we say this is important enough, do we get distracted by the next shiny thing and we never kind of go around to that? Or do we ask people what was important to you or ask them, you know, what kind of competencies should we look at this year? And I like to give them forms and tools to be able to pull all these different pieces and then pull in the strategic plan and filter up to the surface the competencies. You can put ownership, empowerment, and accountability into everything you do if you just take a look at your systems. That's that's where I would start right there.

Host Nicole Weathers 49:55

I think another piece of, you know, sort of that disengagement too is the flavor of the month mentality of, oh, well, we were working on CAUDI last month. I I haven't heard anything about it in a while. Is that something we're still doing? You know, and you begin to question uh when you do have that flavor of the month happening.

A Falls Fix That Worked

Donna Wright 50:16

It just allows people to understand why we're doing what we're doing. When they are part of the selection of the process, and that's key to it, and they understand that, okay, we have a problem with this, or here's a new thing, and here's why we're doing it, then then people are much more um, I guess, you know, committed to it. They say, we understand why. Um, and they're part of the solution. Okay, so here's a story that really kind of exemplifies that. And this is a group um up in Montana that was using my competency model for about three or four years. They sat down to select their competencies. It was the shared governance council, the manager, and the educator all together in the cardiac area. And they were saying, okay, what's what's new, changing, high risk, and problematic? They were using a selection worksheet that I I recommend. And um, so they were, they saw that one of their problems they were having was with falls. They were having a lot of falls yet again this year, like last year and the year before. So somebody on the team says, Oh, we're gonna have to do the falls competency again. And so they said, Okay, yeah, we have to do that. And then somebody said, Why? Why would we do it again? We did it last year and the year before. We all passed, and it didn't, falls didn't get better. So why would we do it again? That's the definition of insanity. And they said, Yeah, and they said, but you know what, what are we gonna do? I mean, our falls are in the toilet, we gotta do something. And someone said, Well, let's just think a minute. I mean, we don't want our patients to fall. We put the red bracelets on them, we put the red socks on them, we put the thing over the bed that says false precaution. We talk about it in Huddle. Why is this still a problem? And then somebody said, Well, you know, when is it happening? Where is it happening? Well, who's involved? And they said, Let's pull all of our QA data, our quality data, and look at all of the data and figure out what's really happening in our backyard. And they noticed when, well, they had two falls on one day, and somebody said, Oh, I was working that shift. It was crazy and chaotic. And then somebody said, I was working on this day and we had a fall and it was crazy and chaotic. And then another person said, Me too here. And they realized that every day they had a fall, they had um, it felt like a crazy and chaotic day. And they said, Could it be that falls is not the problem? Falls is a symptom of something else. Could it be that us being able to manage a crazy and chaotic day is actually the skill we're missing, not the knowledge on falls? And they said, Well, maybe, but how would we even do that? I mean, would when we make it a competency, what would we do with that? And so they said, Well, who's good at de-escalating, you know, craziness? And they said, Well, maybe behavioral health can help us with de-escalating crazy. I don't know. They called over to behavioral health and they said, Oh, yeah, we got like three competencies we could show you and and behavior. The psych people helped the cardiac people come up with a competency on de-escalating craziness on your shift. And everybody on the cardiac unit that year did uh one of their five competencies that they selected was on de-escalating craziness in the day. Everyone had to show that they could do it. There were different ways they did the verification of that, very creative ways. And uh they did one of their five competencies for that. And what I love um was that at the end of the year, after everybody did that, they dropped their falls by 68%.

Host Nicole Weathers 53:34

That is incredible. And that is kind of that is what we need, right? Because when I think about competency, it feels like it's so much easier to just say falls is an issue. Let's do the false competency again. Let's not think beyond that. Let's check the box and move on. And that is why we I it seems to me anyway, that that is why we get stuck with continuing to not have the outcomes that we are trying to achieve because we keep doing the same things and it's clearly not working.

Donna Wright 54:06

And then what I love is this group called me. I wasn't even there. They called me to say, Donna, we're so proud of ourselves. Here's what we did. And they said to me this if we didn't own our competencies, if we didn't have the right to select our competencies based on data, they don't just get to pick anything they want. They said, we wouldn't have asked the second part of the question. They knew the data on falls was in the toilet. They knew that. But they said, what else is missing? And what was missing was their gut feeling of the day. There was more data than just what the quality department could give them. It was their own data to say, what did that shift feel like? What did that day feel like when we had the fall? And that was a second component of information that got to the real issue. And they made a difference in their patients. And they said to me, we made it safer here for our patients on this care area. And they were so proud of that. You know, that's what we want. And it's not about that from up above that we're not gonna, you know, focus on falls. Of course, everyone's focused on falls. So if your data falls below or above where you need it to be, you got to do something about it. And we gave permission to the team to do something about it.

Future Skills And Culture Shifts

Host Nicole Weathers 55:15

That is such a cool story. Thank you so much for sharing that. So much to learn, I think, um, about about competency, about that ownership, about empowerment, about account, you know, accountability uh from that story. So really cool. Okay, so looking ahead, I want to kind of switch switch roles here and and think into the future a little bit. You know, as our nursing workforce continues to evolve, as, you know, change probably continues at an even rapid, more rapid pace than it is already. How do you see competency evolving?

Donna Wright 55:55

Um, very good question. I think it's back to creating competencies that really matter. I've seen some shifts in the way people are actually looking at competencies rather than, again, the procedures and tasks and how to uh operate a machine and things like that. I've seen people that are looking at a competency like uh during orientation, the ability to learn on the fly. Show me not just, I'm not just gonna tell you you could look it up. I want you actually to prove to me, show, show to me four times that you can go get you that you can show that you know something or don't know something, and you can go look it up. You can call somebody that um during when I'm precepting somebody, I might say, um, if they ask me, well, how do I do this? And I say, okay, would you like to use this as one of your learning on the fly competency verifications? Or do you want me to just tell you what to do here? And then the new employee can, like, oh my god, I don't know if I'm ready yet. Okay, yeah, okay, I'm gonna give it a try, you know? And then you have to then show me uh what you don't know and where you would initiate your own education, look it up because I want you to demonstrate to me that you can use our resources, you can access stuff, you know who to call. It's not about knowing everything. We all know that. The scariest professional on the planet is someone who says they know everything. That's not realistic. The best professional is someone who's always curious. I think I'll look it up again. What other outcomes could we have with this that might impact what's going to happen? You know, all of that stuff. So that's an example of one. The ability to learn on the fly. Uh, I've done some other attitude competencies. I've done some things with some groups where we just finished one in an emergency room to distinguish between what's urgent and what's important. What you need to respond to right now and what's important, it could be high risk, but you have time. So you can slow the roll. They called it the slow the roll competency, you know? So you could distinguish is this an urgent thing or is it an important thing? Because that makes a difference in how we respond and our purposefulness on deciding the actions we take. It's not about running the machine, it's a different way of thinking in the emergency department. So I think our competencies are gonna look very different in the next five to 10 years.

Host Nicole Weathers 58:09

I think they're gonna need to too. Like I think that um we can't keep, you know, checking lists and checking boxes in these silos that we do really have to look at and how is it, how are all of these, the bigger picture of all of this being applied? Um, you know, when you talk about that learning on the fly, to me, this seems like something that is just innate for me that I'm always like, well, I don't know how to do that, but I can probably figure it out. It seems though, and I don't know if this is a generational thing, and this might be a tangent that we can cut later if we need to, but like, is this something that is missing in a lot of people? Um, that they they just expect that they a should know it, or if they don't know it, they just they don't know it. Big deal.

Donna Wright 58:57

Do you see that missing? Yeah, I think I mean, I will say I'm I'm going on my 40th anniversary as a nurse here pretty soon. Um, and I heard this back when I was a young person too. And I think sometimes we say it could it be that that that's the people have they changed? I think it I've seen different groups where some do well with us and some don't. You know, we've all probably experienced somewhere. Well, someone say, didn't they teach you that in school? Are you gonna be willing to ask more curiosity questions in the future when you get that kind of response? No, because that's your culture. I've also been a part of other cultures where the very experienced nurses would sit around and have some discussion amongst themselves, even during breaks or during report, and say things like, I'm just not getting the results I need from this situation or this these interventions I've been using. Does anybody have some other ideas? And they reflected with each other and with each other. And I thought, this is a nurse of 30 plus years of experience and they're still not certain. That was such a good thing for me to see. So I think, I think it's more about culture than it is about generation. I think, yes, there are differences with our generations. I get that. And that's not, I'm not wiping that out because there's different reasons we get motivated about things, but the connection, the passion we have for something, um, I think comes from the culture that allows this or that to happen within an organization.

Host Nicole Weathers 1:00:24

No, I think that's what it is. Like I, you know, I asked the question genuinely because I I wasn't putting that connection to culture there. But I do think that's what it is. You know, if you're if you're in a culture that encourages that type of behavior and models that type of behavior, you're gonna more likely develop those types of thinkers and those types of nurses.

Donna Wright 1:00:46

Absolutely. And I I rob from other industries uh blindly, I mean, just blatantly. I love it. So it's great. But uh in the airline industry, you'll see over the last decade or more, you know, they changed how um the you hear people talk about the door from the cockpit to the uh back of the plane. There was a hierarchy there that they purposely tried to dismantle. And now when you go on a plane, you can hear things like the pilot saying, Um, uh, welcome aboard this this plane today or our flight, blah, blah, blah. And you have we have an exceptional crew in the back. They give great respect to the crew versus before it wasn't, it was more I'm the captain, do what you're you're told. And they said that affected the ability for that team to function together. So I think uh a lot of times we have to examine what culture are we in? Is that the culture we want? What components do we want to keep or change? Um, it comes down to mostly culture. And it could be even culture within teams that are different from other teams in the same organization, or even shifts sometimes too.

Host Nicole Weathers 1:01:51

So, well, Donna, I have learned so much from you today. I'm so grateful for this conversation. You know, we've talked about competency, what it is, why it matters, what it's influencing, where to start, even thinking about into the future how things will evolve. Uh, before we go, though, I do have one last question. And I do ask this of pretty much every guest that comes on the podcast. Um, but when you think about competency and you think about the impact that competency has, what's one strategy that you see organizations using that you think makes the biggest difference and something you wish more organizations would adopt?

Donna Wright 1:02:28

Hmm, that's a very good question. I think just to have a reflective conversation to say what do we like or not like about our current um culture or process and put them into some categories. Because too many times organizations stay with the things they don't like just because it's familiar. So because they're comfortable there and they hate it, you know, the checklists, let's get rid of them. But oh, it's easy. I mean, we use that term several times during this podcast, you know, because it's easy. Easy for what? To not get to our goal, you know, that's not an excuse. So I think just I think awareness is so good to say what do we like about our process? Because you don't want to throw the baby out with a bathwater. But at the same time, let's not hold on to stuff we don't even like, and we've been whining about it for years. So to say we want to move to something that holds this to be true and keep it there, but get rid of the stuff that does not serve us well. Um, simple things like that. I even say with every policy that you have in your organization, I always ask the question you read a policy, does it serve you or does it control you? If it controls you, get rid of it. If it serves you, keep it. And that's where we go next because that will shape the culture.

Host Nicole Weathers 1:03:43

That is so great. I mean, thinking about, you know, um, being brave enough to try something new.

Donna Wright 1:03:50

And we don't have to change unless the change is warranted. I'm I don't want to take people to someplace completely new where they don't feel comfortable. But again, being aware of what you like and what you don't like. Um, you know, every everything in life is like that. You just change a job, don't jump off to a new job without saying, I really like this part of my job, I want to keep that. Or you even said to me earlier today, you really loved working with people and developing people. You didn't even know that for at, you know, when you first started in your nursing profession, but you love that. So as you move on to other things, you want to keep that part that you love, but you might want to get rid of this or that. I like to work indoors or outdoors. I want to travel more, I don't want to travel as much or whatever it might be. You need to know the pros and cons of everything that go with it. So excellent.

Resources And Closing

Host Nicole Weathers 1:04:37

Well, thank you, Donna, so much again for this conversation today. Um, I'm I'm really glad that you were able to join us, and I know that our listeners will walk away with just as much, if not more, uh, than I did. Thank you, Nicole. I appreciate it. Wait, before you go, I want to make sure you know all about our suite of resources you can use to support your new graduate nurses. This includes our Academy, a coaching program designed for organizations as they prepare for the implementation and ongoing sustainability of a nurse residency program. Work one-on-one with residency program experts to make sure your organization is residency ready. Our Clinician Well-being course is an asynchronous online course that aims to enhance the well-being and resiliency of healthcare professionals, equipping them with the necessary psychological capital to navigate challenges inside and outside of work. Supporting nurses is another asynchronous online course for preceptors, mentors, and coaches to learn the skills they need to support any new hire. Both of these offerings can be used as a standalone professional development opportunity or to augment any nurse residency program. And we can't forget about the program that started it all the online nurse residency program. This includes a comprehensive curriculum designed. To support new graduate nurses applying all the knowledge they learned in school to their practice. We focus on professional skills, personal well-being competencies, and new graduate nurses even get the opportunity to create real change in their own organization. Offered completely online and in a blended format, this program is highly adaptable to all clinical practice settings. You can learn more about all of these programs and more of what we offer using the links in the show notes below.