Students preparing for future careers in nursing or business have very different work environments ahead of them. But graduates in any field -- including nursing and business -- are finding it increasingly common to enter leadership roles early in their careers.
To address this changing landscape, the Indiana University East School of Nursing and Health Sciences and the School of Business and Economics are pairing students together to help their students to develop leadership skills. Then, in collaboration with IU East's clinical education partner, Reid Health, the students work together to tackle challenges and improve processes related to health care topics identified by the hospital system.
Although similar courses are taught at several IU campuses, IU East is the only campus where the challenges used in the course are identified by a real hospital system, or where the results of the students’ work have the potential to impact real quality improvement initiatives. Reid Health is located adjacent to the IU East campus, and its where most nursing students complete a significant portion of their clinical rotations.
"We're seeing more and more students move from bedside to leadership roles shortly after their first job," said Amanda Carmack, an associate dean and assistant professor at the School of Nursing and Health Sciences at IU East. "It used to take at least five years to earn the position of 'charge nurse,' where you managed a team. That’s no longer the case."
The rapid shift in career trajectories is due to a number of factors, but shortages in the field and high workplace turnover fueled by the pandemic play a significant role.
"Healthcare has changed; it's important that we change with it," said LaDonna Dulemba, associate professor of nursing at IU East, who co-teaches the course. "We don't want our graduates learning on the fly. It's important they’re exposed to basic concepts such as management, organization and leadership before they're called upon to master them on the job."
Dulemba is teaming up with Rebecca Clemons, an associate professor of management at IU East, who specializes in "Lean Six Sigma," a widely accepted method of improving communication, increasing efficiencies and identifying points in processes with high risks of error or bottlenecks.
Over the course of a semester, nursing students organize into small groups to tackle challenges related to quality improvement initiatives at the hospital. These initiatives focused on specific topics such as obesity, cardiovascular disease, sexually transmitted infections, depression, lung cancer, diabetes and infant mortality, which are identified based meeting the needs of clients in Reid Health's service area.
Among other lessons, students are asked to organize the steps needed to provide care for these conditions – ranging from the intake process to outpatient care and long-term health maintenance -- into "swim lanes" based upon what part of the hospital system is responsible for each function.
The nursing students then collaborate with the business students from Clemons' class to confirm or revise the students' analysis, after which the nursing students produce a report and deliver a presentation at the end of the course. The results of the reports are then delivered to Reid Health's quality improvement department for integration into their efforts on these subjects.
"Quality improvement is very abstract; nurses tend to get very focused on the patient so it’s difficult to think on a systems level -- that bird's eye view is very foreign," said Clemons. "The students' tend to appreciate the experience after they've had it, however. And getting feedback from the business school is essential to validating their learning experience."
Ashlyn Hubbard, a recent B.S.N. graduate at IU East, took part in the course as a senior this May. She was a part of a work group focusing on depression in young adults.
As part of the process, Hubbard said she and her fellow students worked to gain a deeper understanding of their topic, reviewing information such as common statistics on depression, as well as research on alternative treatments and side effects.
They also used organizational concepts from the business world to conduct their own work, assigning roles and duties within the team based on a process known as the PDSA cycle, or "Plan, Do, Study, Act," a four-stage method designed to integrate continuous change and improvement into a team’s work. Hubbard said the experience helped her understand how a team can most effectively change course and remain open to new ideas, while still completing a task.
"I feel like this experience really helped prepare me for my future career," she said. "I'm interested in becoming a charge nurse, nurse practitioner or certified registered nurse anesthetist in the future. With all of these roles, you really need to be open to change -- and also understand how to make it happen effectively."