A role model for nursing leadership

Challenging the profession to change its way of thinking has earned a Melbourne nurse a major award.

Robynne Cooke is not a nurse to be trifled with. As chief nursing officer of the major healthcare network Northern Health, she has elevated nursing at the organisation to its rightful place – at board and executive level. 

It is this commitment to nursing leadership that has earned her the Deakin University - Health Super 2010 Leadership in Nursing and Midwifery Award.

“This award not only recognises the importance of nursing as a profession but the importance of nursing leadership if we are going to achieve the best possible outcomes in patient care,” Cooke says.

Upon her appointment in late 2009, Cooke quickly recognised that nursing at Northern Health was fragmented and often operating in silos. To address this, she developed what she calls a ‘10 point nursing plan’ to bring together the operational, workforce and educational areas of nursing across the organisation.

At the top of the plan was the establishment of a nursing executive, initially comprised of six directors of different nursing portfolios across the network. The nursing executive now works in conjunction with senior management and reports directly to the executive and ultimately the board.
This has ensured that key decisions affecting nursing across the organisation are approached strategically and that the nursing workforce is driven by strong and relevant leadership.

“Northern Health services one of the fastest growing areas of Melbourne, caring for more than 500,000 patients per year, so we needed to get nursing right,” Cooke says.

“To connect nursing with the rest of the organisation and create a shared vision and leadership, it was imperative that nursing be represented at the decision-making level.”

Although her new strategic direction for nursing at Northern Health has only been in play for 12 months, it is already showing positive signs of success.

This includes a re-energised workforce, a higher quality of patient care and an enhanced reputation for the organisation.

“There is a real buzz about the place, and our nurses are more confident about their job and proud to work at Northern Health. If that’s what good leadership does, then I’m on the right track.”
Cooke believes that nurses must always strive to be more than average and that they must be accountable. She also believes that they must never lose sight of the fact that their primary responsibility is patient care.

“We are the biggest and most expensive workforce in the healthcare system, so we have to be accountable,” she says.

“To be a nurse is a great privilege. When we are with a patient, they are at their most vulnerable. So, we have a professional responsibility to give them the best care that we can.”

For Cooke, this has sometimes meant being prepared to confront poor performance or bad behaviour head-on. But this is all part of her plan for raising the standard of nursing at Northern Health and ensuring that the organisation has a committed, educated and respected nursing workforce.

An important part of the plan is to build a strong and capable nursing workforce to help meet growing demands. This includes investing in nursing education and training, professional mentoring and strengthening partnerships with key universities.

Another part of the plan is to develop a workforce strategy and succession plan to deal with the national nursing shortage and an increasingly casual and multicultural workforce.

“We need to change our thinking about nursing and how it operates. Instead of the ‘one nurse to four patients model’, we need to look at delivering patient care as a team, using complementary skills and our more educated nurses, many of whom have double degrees,” she says.

“We also need to look at how we engage our casual and migrant nurses, who may have different needs and expectations.”

As winner of the Deakin award, Cooke receives $20,000 to put towards nursing education and professional development. She says she would like to create exchange programs for nurses to visit healthcare facilities overseas to share knowledge and ideas, gain cultural insights and learn different ways of doing things.

“Victoria has one of the best healthcare systems in the world, but we can still learn a lot from others. We don’t know what we don’t know – so by sending our nurses overseas and plugging into the rest of the world, we might just come to know a lot more.”

For herself, Cooke says that she is very lucky to have a job that that continues to “make her heart sing”.

“Nursing is a wonderful profession and I have been privileged be part of the development of nursing in Victoria. I hope that through my own leadership that the nurses at Northern Health can feel the same way.”

Finalists
For excellence in nursing and midwifery leadership in an urban healthcare environment: Lynn Bickerstaff
Lynn Bickerstaff is director of nursing/operations for the Rehabilitation and Aged Care Services Program and director of nursing for the Medicine Program, Southern Health. In this role she has implemented a comprehensive, strategic and visionary plan to develop and embed leadership, and commitment to the delivery of quality care, within all levels of nursing in Southern Health’s Rehabilitation and Aged Care Services Program. The program has been focussed on nurse unit managers (NUMs) as the most important group of staff when it comes to influencing staff performance and patient care outcomes.

For excellence in nursing and midwifery leadership in an regional healthcare environment: Therese Cotter
Therese Cotter has led a strategic planning process with a multidisciplinary group of clinicians from various levels within Barwon Health to implement two new initiatives; the midwifery group practice and post natal model of care. The aim was for the first time to redesign maternity programs to improve the level of continuity of care provided and to focus on providing truly ‘woman centred’ care. Evidence based postnatal care is not provided at any other health service in Victoria. Cotter’s leadership in advocating for ‘one to one’ care by a midwife for every woman and for pregnancy care to provide a seamless transition between services has seen the engagement of families with early parenting services and care has assisted to bridge the gap between policy, evidence and practice.

For excellence in nursing and midwifery leadership in a rural healthcare environment: Megan Holmes
As part of a larger project initiated by Australian Centre for Evidence Based Aged Care, Megan Holmes has developed a model of care aimed at improving management strategies for residents who live with dementia. She has been responsible for educating and guiding a team to deliver a person centred approach to caring for those with dementia. As a result of the program, major changes have resulted in the attitudes of the staff who work in the dementia specific unit. A further outcome has been the establishment of a “Behaviours Committee” to help identify areas of concern that can be addressed, and to facilitate behavioural assessments and the development of appropriate management strategies.

Highly commended certificate: Dr Andrea Driscoll
Dr Andrea Driscoll has undertaken an exemplary leadership role in the nursing management of individuals with heart failure. While undertaking her PhD she undertook strategic research projects to investigate crucial elements of nurse-led interventions and factors impacting on advanced practice nursing roles. From this and subsequent work she has led the establishment of a nurse-led titration clinic that is unique and innovative. A rigorous evaluation has demonstrated an improvement in patient outcomes through improved health service delivery.

 

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