Thinking Outside the Box - Emerging Nurse Leader

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

“The creative process is also the most terrifying part because you don’t know exactly what’s going to happen or where it is going to lead.” Stephen Covey

Last week, I talked with a group of perioperative directors about leadership succession planning. They had many concerns about the lack of nurse leaders in the pipeline to replace retiring perioperative directors. I asked the group whether any of them had assumed leadership roles in this area without OR experience. Interestingly, several of them had become perioperative leaders without OR experience. One perioperative leader from a large health care system spoke up and said that when her OR manager retired, she had little luck in finding a replacement. I decided to try a different approach. I picked out one of the best managers in our hospital and met with her to discuss whether she might consider a leadership position in the OR. This manager had extensive labor and delivery experience. She was intrigued and took the role. Leadership was not new to her but the OR was and she steeped herself in learning about the specialty. It has turned out to be a fantastic match. She loves the OR and the staff respects her.

The box is a frame, the traditional way of thinking about a problem. Faced with a dilemma, the nurse leader in the above case situation was willing to think outside the box in solving her problem. Had she not done so, it is possible that her OR might have been without a manager for a long period of time or perhaps used an interim management service. There are risks to moving outside the box but there can also be great rewards. With the current turmoil in health care, new innovative and potentially disruptive ideas will be needed. So here are five strategies to improve your ability to move beyond the box as you face your challenges:

1. Ask yourself whether your issue or challenge can best be solved using a traditional approach – if not, then it is time to be innovative in your thinking.

Not every issue or challenge requires out of the box thinking. Many problems can be effectively solved using a more conventional approach. But sometimes to achieve more effective outcomes, innovative thinking is required. In the case situation above, the traditional approach to recruiting an OR nurse manager was not effective.

2. Consider the problem from an entirely different vantage point.

When we are willing to examine a problem from an entirely different vantage point, our thinking can become more creative. Asking ourselves what is really needed here becomes important. When looking at the OR manager position, this leader was able to ask the question as to whether she needed a clinician or were strong leadership skills more important? She had an experienced OR staff with few new graduates who needed coaching. Business skills were an imperative. To think outside the box, you need to ask “Is there another way to think about this?”

3. Seek ideas and input from others.

Seeking the opinions of others can help in the creative thinking process. As a nurse leader, you can improve your out of the box thinking if you seek ideas from those outside of your own profession. Ask yourself how things are being done in other industries. What ideas can be applied to this situation.

4. Identify at least three different approaches to solving a problem with at least one approach being outside the mainstream of how you would usually manage a challenge.

Challenge yourself to identify at least three different approaches to solving a problem. Getting out of the box means sticking with the problem longer, and looking at it from various sides. This requires a willingness to take new perspectives to your day-to-day work. In the box thinkers often believe that every problem needs only one solution; therefore, finding more than one possible solution is a waste of time.

5. Never dismiss a possible solution on the basis that it can’t be done. Consider everything. Go through every possibility until you know for a fact it can or cannot be done.

Challenging your own assumptions can be the most difficult part of out of the box thinking. Just because something has always been one way, doesn’t mean that it has to continue to be that way.

Out-of-the box thinking requires an openness to new ways of seeing the world and a willingness to explore. It means considering other innovative options as the nurse leader in our case situation was able to do while recognizing that new ideas need nurturing and support. Even great creative people can become in-the-box thinkers when they stop trying. As nurse leaders, we need nurture our ability to think outside the box and promote this skill in others.