Nurse Consultants: developing clinical leadership through collaborative learning and research: the role of action learning.


When did you first introduce the innovation?

Between 12 and 24 months ago

Please describe the innovation you have developed

In October 2013 I set up a modified Action Learning Set with three Nurse Consultants,fairly new in post and an established Physiotherapist consultant in the same District General Hospital. I set up the ground rules and started them off. The consultants then met monthly and developed a personal grid depicting the four areas of the consultant role to track progress and raise issues of concern. They shared this with each other prior to each meeting and took it in turns to share their areas needing to be discussed. I met with them every three months. The three consultants fairly new in post knew each other but not very well. Each of them was struggling with different issues, some of which was wrestling with taking on two roles (their previous role in the organisation which they found difficult to shed and their new). They also had to establish credibility with their staff and the medical staff and they struggled to make the changes they wished to make. All found their role isolating. They gained in confidence and retained their monthly meeting which they found immensely valuable and are now taking key leadership roles within the Hospital in addition to the new services they were introducing.

What prompted you to develop this innovation?

From a previous commissioned study of Nurse consultants’ publication record from across a wide geographic area (which for the most part was negligible), a planned meeting with the new in post, Director of Nursing (who in a previous post was a consultant nurse) I offered my services to facilitate an action learning set with her consultants to assist them in developing their wider portfolio. Apparently she had had a similar experience in her previous role as consultant, with a professor in a neighbouring university and she became very enthusiastic about it. The consultant nurses, new in post were keen to be valued sufficiently to be given the time to devote to this on a monthly basis.

In your view, what is it about this innovation that makes it different/important?

It was bespoke and made a significant difference to their working lives, very soon after commencing. We also presented at international conferences and published a book chapter on evidence based practice. The Director of Nursing gained their significant leadership for the institution rather than simply for their own service.

To what extent does your innovation make use of existing approaches, resources or technologies?

Action learning sets have been used widely but this was modified in as much it did not stick strictly to the advocated process and allowed some flexibility. One of the consultants had been involved in a previous action learning set which was rigidly adhered to and she found it unhelpful and took pains to ensure that we accommodated some flexibility.

To what degree has this innovation led to changes in education or clinical practice?

The consultants have met with the medical director of the hospital who is now becoming familiar with the role of Consultant nurses/therapist, they have gained considerable credibility in the organisation and not only lead their own services with confidence but are taking on organisational leadership as well. They are individually extending their scope of practice in publishing, taking on additional study, bidding for research grants and leading their teams with conviction. They have begun to ‘think out of the box’ in terms of reaching out nationally to their counterparts in other institutions to help develop themselves in their roles.

What evidence do you have of the impact of the innovation?

We have presented at three international conferences and one local conference and one book chapter on evidence based practice (in press). We are currently undertaking a co-operative inquiry to evaluate the action learning set and it is clear that the impact has been considerable on themselves as individuals, on their role,their teams and their organisations. Ultimately it has an impact on patient care.

To what degree has the innovation been disseminated in your organisation or elsewhere?

I have disseminated it to the University team and at three international conferences.

Please provide details of any plans you have to disseminate the innovation in the future.

I plan to continue the evaluation and publish several papers from the outcome and to encourage each of the consultants to take the lead on one of them.