By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Albert Einstein said that “we cannot solve our problems with the same thinking we used when we created them.” I agree with Einstein and am now uncomfortable with nurse leaders who talk about consensus panels and evidence-based strategies to navigate our way out of the current nursing crisis. If we wait until we gain consensus or have the “data” we need, the crisis will likely worsen. Innovation rarely happens through consensus panels. Peter Sims, the author of Little Bets, makes the compelling case that small bets lead to innovation and breakthrough ideas.
Little bets are defined as concrete actions to discover, test, and develop achievable and affordable ideas. They begin as creative possibilities that get refined over time. Sims points out that taking these little bets is particularly valuable when navigating amid uncertainty, creating something new, or attending to open-ended problems. As nurse leaders, we often focus on widespread systems changes to solve problems. Sims makes a strong case that taking small bets to test out new ideas is often more effective in leading to the type of innovation needed in healthcare and other industries today.
Examples of Small Bets I am Hearing About Right Now in Nursing
- Navigating the nurse mental health crisis by providing each nurse with a paid time off mental health assessment – using an opt-out versus an opt-in strategy.
- A pay to stay in 2021 retention program with incremental bonuses for staff every four weeks.
- Employing a nurse retention coach who meets with every nurse who has submitted a resignation or is considering leaving.
- Hiring any interested members of the senior BSN class to work as PCTs while getting clinical hour credits.
- Re-employing retired nurses into a Nightingale Program where they self-schedule according to their availability and work 6-hour shifts.
- Placing all new graduate residents into a pool where they rotate across multiple units.
- A per diem nursing program for nurses who want to work 4, 6, 8, 10, or 12-hour tours.
- Using retired nurses to do admissions/transfers/discharges remotely with patients using IPADs.
- Allowing young moms to job share nursing positions and assume responsibility to cover a posted schedule.
- Partnering with the YMCA to start evening and weekend childcare while giving childcare workers coaching and reimbursement to start nursing programs.
- A compassion fatigue program that focuses on allowing nurses to debrief on their COVID-19 experiences.
- Providing nurse managers with the option of working four ten-hour tours.
- Cross-training every new nurse to two different clinical areas.
- Hiring an interim manager to cover nurse manager time off.
- Centralizing scheduling and staffing to reduce the 60% of the time leaders currently spend on this activity.
- Consulting with national retail, airline, and hotel firms about more innovative scheduling.
Some Key Steps in the Small Bets Approach
1. Be Willing to Experiment
Sims recommends that we must be willing to experiment with new ideas and fail quickly to learn fast. Even if an intervention fails, you learn from the experience.
2. Value an Atmosphere that Promotes Creativity
To promote Creativity, you must create and value an atmosphere of innovation. You want to avoid snuffing out or prematurely judging creative ideas as not doable like childcare.
3. Take Time to Gather Fresh Ideas and Insights
New insights and ideas are all around us but not always obvious. Nurse leaders need to take the time to get out into the world to gather fresh ideas and insights. It involves reading outside your professional literature to spot trends and environmental changes. The goal is to develop a deeper insight into human motivations and desires and absorb how things work at the front-line level.
4. Implement, Refine and Retest
Rarely is the initial design of a new process or business – the final product. By arming ourselves with new insights through implementation and refinement, innovations are perfected. We have to develop a willingness to see things as works in progress before abandoning new ideas too quickly.
Leaders often fear failure because they believe that innovation needs to be unleashed on a massive scale to have meaning. Sims contents that the practice of simplifying problems and taking small bets can be quite liberating and result in unexpected innovation. Most change, he contends, happens in small, achievable ways. This is important advice for nurse leaders to embrace as we work to solve our workforce crisis.
Read to Lead
Sims, P. (2011). Little Bets: How Breakthrough Ideas Emerge from Small Discoveries. New York: Free Press.
© emergingrnleader.com 2021
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