Expanding Your Mental Models - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

I recently had a discussion with a CEO about the span of control of nurse managers. I have growing concerns about what we are asking of these frontline leaders to do and wanted to elicit his viewpoints on the topic. It soon became clear to me that his mental model of the manager is not grounded in the reality of day to day clinical practice. He believes that because nurse managers are leading professionals who are accountable for their practice – that it should not be unreasonable for them to have fairly large spans of control. In the best of all possible worlds, that might be true but this is not the current healthcare environment.

All of us have mental models that serve as a lens or framework to explain how things work in the world. Mental models shape our behaviors and set an approach to how we solve problems. In interprofessional education, we recognize that one of the first steps to getting teams to work more effectively together is the sharing of each professional discipline’s mental model of patient situations. It is important to understand these thought processes.

Mental models are useful but they can be imperfect when we need to look at situations in different ways. Like the CEO that I talked with, we all have our favorite mental models, the ones we naturally default to as an explanation for how or why something happened. To see things differently, we need to expand our mental models. Your individual mental model is just one view of reality. When we become aware of our mental models, When we are able to become aware of our mental models, we should ask ourselves what led us to this way of thinking or feeling. We should also challenge our beliefs and assumptions. A key way to do this is by asking questions and spending time with individuals who have viewpoints other than our own.

My suggestion to the CEO was that he spend one day with a medical-surgical nurse manager in his facility. My advice was to go to the unit and shadow the manager observing what he or she does throughout the day, who they interact with, what challenges they have and how they spend their time. If you ever watch the TV show Undercover Boss, you can see in real time how these company leaders develop a much deeper appreciation of the work of staff.

I am fairly certain that just one day on a medical-surgical unit might change this CEO’s mental model.

Read Rose Sherman’s new book available now – The Nurse Leader Coach: Become the Boss No One Wants to Leave