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Healthcare’s volatility gives way to innovative leadership

By | September 25 th,  2018 | Beverly Malone, clinical leadership, organizational power | Add A Comment

Beverly Malone strengthens her leaders by empowering them


malone-2018Today, the world of healthcare is imbued with a nonstop barrage of change, and Beverly Malone, CEO of the National League for Nursing, says she thinks leaders should get excited about that.


“Yes, times are volatile,” she says, “but, as a leader, you were born for times like these. It’s not just ‘one potato, two potato’ anymore. When you can bring folks together and reassure them they’re in the right place at the right time doing the right things, it doesn’t get much better than that.”


Malone has served as dean of North Carolina A&T, president of the American Nurses Association, and general secretary of the Royal College of Nursing in Great Britain, where she oversaw all nursing in the U.K. She says leadership isn’t easy but is incredibly rewarding.


“When you are a leader, there are times when there is a lot to carry,” she says. “Sometimes, you have to hold the boundaries of the organization in your mind and heart. “


Strengthening leadership teams


Collaboration in leadership is the key, adds Malone, who earned a PhD in clinical psychology.


“I believe in situational leadership,” she says. “It’s like a dance. There are times for me to step out front and lead, and there are times for me to step back and let someone else lead.”


That philosophy helps Malone select, focus and engage her leadership team.


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“Selection is about understanding what you already have, and what are the gaps on your leadership team,” she says.  “I look at it as, ‘I’ve got this dream, and I need expertise in this certain area. Let me find this person and try my best to move out of the way.’ I want them to help build the culture. Some level of trust on my part is critically important.”


The need to create alignment on a leadership team is universal. Many leaders utilize personality assessments with their direct reports to better understand the dynamics that occur on their teams, and to look for ways to address the gaps that Malone speaks about.


With a lot of turnover in the executive ranks of healthcare, the need to address executive team performance is urgent to keep leadership teams rowing in the right direction. Behavioral assessments and the work of organizational psychologists can help CEOs keep their C-suite on track.


Situational leadership is a delicate balance that takes an extremely intuitive leader to execute. Many factors play a role, including:

  • Experience and preparation of the team member(s) in this type of situation or achieving a certain outcome
  • Level of support given at any point throughout the execution of a project or initiative – this can wax and wane depending on several factors both internal to the team and organization, as well as external influences such as stakeholders and the community
  • Amount of direct involvement from the leader in the actual execution

This type of leadership can allow teams to become stronger as a whole, but leaders, such as Malone, must be adaptable and in tune with not only the inner workings and talents of their team members, but also the nuance of the situation at hand and the possible challenges posed from stakeholders.


Empowering your direct reports


Malone says delegation, while it is a basic building block in leadership, is an important component of trust at all levels of an organization.


“I think there’s some level of authority that each person has to have in order to feel good about their work. If they don’t feel authorized, and subsequently have an inability to get things done, then I have not succeeded as a CEO. That’s really a huge part of what we do at the NLN. I’m not the only who does the visioning and dreaming.”


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To delegate and mentor as a CEO, one must understand the types of organizational power (first outlined by Raven and French in 1959) and use them carefully, she says. They are:

  • Informational or expert power: Knowledge.
  • Legitimate power: Authority in a hierarchy or earned authority, such as nursing or physician license.
  • Charismatic or referent power: Power based on personal traits and how others view you.
  • Reward power: Power given to a person. In the workplace, this might be authority over a project, promotion or a raise.
  • Coercive power: The opposite of reward power. The power to take away or withhold rewards.
  • Extended power: Mentoring.


To build high-functioning leaders, extended power is an underestimated force in an organization. Some teams falter because there is so much turnover in healthcare’s executive ranks. Extended power builds the pipeline of talent, aids executive succession and improves the retention of high-performing leaders.


Malone puts it this way. “As the CEO, I can’t know or do it all. I want my team to be self-authorized.”


Leadership for clinicians


Self-authorization is something all nurses do every day the moment they step into a patient’s room, Malone says, and that trains their leadership abilities. If a nurse aspires to become a chief executive officer or a chief nursing officer, that self-authorization, along with humility, will serve them well.


“Our values here at the NLN describe ‘excellence’ as co-creating and implementing transformative strategies with daring ingenuity,” Malone says. “But you don’t do anything by yourself. If you can put together a team that will create those strategies with you, then you’ve got something.


“As a leader, every now and then, you will fall off a cliff. Falling is OK. It’s getting up that’s important. And, if you have that transformative team around you, they can help you get up.”


By allowing your team to stretch their leadership “muscle” not only in calm waters, but also within the eye of the storm you will see what they are capable of, and you might just be surprised at the innovation that is born from such practice. 


EXECUTIVE’S TOOLKIT: Mentoring is essential in the board room too


Organizational dynamics come into play at the board level just as much as the rest of the organization, says Malone, who has served on many boards over the years.


“Board work is really group work at its best,” she says. “You have to decide what the components of governance will be for your organization. Some of it is political, some of it is fiduciary, and some of it is administrative.”


One of the secrets to developing a strong board, says Malone, is peer mentoring.


“Onboarding for board members is an understanding and appreciation for why they’re there,” she says. “What helps is to have a partner, someone who works with them from before the election and makes sure they have all the information they need on governance policies, especially conflict-of-interest policies. Having a mentor is extremely important for a new board member and is essential for their success.”


Rumay Alexander, NLN board president and chief diversity officer/associate vice chancellor for the University of North Carolina at Chapel Hill, says Malone’s expertise inspires confidence in the board members.


“Today’s leaders require the ability to be nimble, resilient, read the trends of change/ trends even before complete, be strategic, innovative, positive and caring,” Alexander says. “Being a leader who happens to be a woman and African-American leading the oldest nursing organization in the country has tremendous challenges. Few would be up to this task but Beverly Malone possesses what it takes to be pre-eminent.”


The “group work” that Malone highlights is something Alexander has witnessed often.


“A hallmark of Bev’s leadership traits is to do right rather than be right so she consistently works to preserve the dignity of others.  Her ability to not only hear but listen and understand multiple perspectives is remarkable.”  


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Once a reluctant leader, Beverly Malone inspires countless nurses with skills that earned her a seat alongside royalty

By | June 27 th,  2017 | Beverly Malone, National League for Nursing, Royal College of Nursing, Modern Healthcare, Blog, Top 25 Women in Healthcare | 2 Comments


One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2017. Furst Group and NuBrick Partners, which comprise the companies of MPI, sponsor the awards.


It’s a rhetorical question, but an honest one, as Beverly Malone, now the CEO of the National League for Nursing, looks over the breadth of her career.


“How,” she asks, “does a girl from Elizabethtown, Kentucky, end up sitting next to Prince Charles?”


Proximity to British royalty was not an accident. The distinguished Malone – who holds a PhD in clinical psychology – spent five years as the general secretary of the Royal College of Nursing in Great Britain, essentially serving as the chief nurse for the nation.


“There’s a little cartoon – the ‘Cathy’ comic strip – that shows her with all of these locks on her door,” Malone says. “And Cathy says, ‘Opportunity knocks, but by the time I get the door open, it’s gone.’ That has never been a problem for me. When opportunity knocks, open the door.”


Malone didn’t initially receive a warm welcome in the U.K. – some were angry that an American was chosen for the position – but is grateful for the experience, which lasted from 2001 to 2006.


“I really believe that healthcare is a right and not a privilege, and their system personifies that,” she says. “Even the most conservative people there – they don’t question it. You are a human being; you deserve healthcare. How different that is from what we have here in the U.S. right now.”


Malone says she also learned that all people, from the prince to then-Prime Minister Tony Blair – are all approachable as people, when you get right down to it.


“Everybody’s human,” she says, “and when it comes to nurses, we can work with everybody.”


Malone was a reluctant leader who was raised by her great-grandmother in a segregated part of Kentucky, someone who encountered a physician only once in the first 17 years of her life.


But her great-grandmother was the town healer, who mixed some basic medical knowledge with an uncanny knowledge of the herbs and plants around Elizabethtown that could ease ailments for people with no money and no access to healthcare.


“She was a bootlegger too,” Malone remembers. “But everyone who came to the house was told to bring a book as well, and she would ask people to read to me. I learned a lot living with her. Everybody kept saying, ‘You’re going to be a leader,’ but I wasn’t interested. All I really wanted to do was grow up and have children.”


Malone did grow up. She did get married, and have children. But with her great-grandmother’s encouragement, she earned her bachelor’s and master’s degrees in nursing and psychiatric nursing, respectively. When it came time to choose a program for a PhD, she says she felt she bungled her interview to study clinical psychology at the University of Cincinnati.


“I figured I was not going to be accepted into a program where I spent the interview arguing with the head of the program over Sullivanian theory and Freudian theory. So, I decided to do the next best thing and have another baby – my daughter was 1 year old at the time.”


There was just one problem. The program did, in fact, accept her. Her interviewer, Dr. Ed Klein, became one of her mentors. And so, she began a PhD program with a 2-week-old son and a 2-year-old daughter.


“That,” she says with a laugh, “was challenging. I don’t recommend it for anyone, but you do what you have to do, and so I did.”


Malone says she thinks she knows why nurses often become sought-after administrative leaders.


“We go into a stranger’s room, establish a relationship and provide services to them that other people can’t do,” she says. “You establish the intimacy of relationship with your patient that is healing in nature. I think that’s what you do in all levels of leadership. People are looking for healing and a relationship and collaboration. That’s a very powerful thing that we as nurses are able to do. And we give with authenticity.”


The nurse who didn’t want to be a leader, who now is a CEO, also served as president of the American Nurses Association. She also was the U.S. government’s deputy assistant secretary for health at the U.S. Department of Health and Human Services. She has even co-written a book on leadership: Diversity and Cultural Competence in Health Care: A Systems Approach.


Malone said she believes diversity in leadership is a work in progress, but is at least moving in the right direction.


“I always talk about it as a zig-zag growth.” She says. You take two steps up and one step back. When you take the one step back, it actually feels like you went one step below your base, but you didn’t. I believe wholeheartedly that we are continuing to move up.”


With her celebrated journey from Elizabethtown to the upper echelons of American healthcare, Malone knows a thing or two about moving up.



SIDEBAR: Signature sayings


Beverly Malone, CEO of the National League for Nursing, is fond of using memorable phrases to illustrate her points on leadership. Here are a few:


Excellence is leadership. “That’s exactly what nurses bring to the table.”


I can be delayed but not defeated. “I am mission-driven. When you are working on something, especially something that is different and creatively unique, you might be delayed. It might take me a while to get there, but if there are things I am supposed to do, nobody can stop me from doing those things.”


Sometimes, you have to feed them with a long-handled spoon. “Not everyone will love you. You can’t get close to everybody. But you still need to serve them. My responsibility is to feed them, but I don’t have to get up close to do it.”


You can’t lead unless you follow. “Leadership is a dance. Sometimes, you lead. Sometimes, you follow. I have a healthy self-image, but sometimes I have to get out of the way so others can lead. I move back so others can move forward. And then, when I need to lead, I move forward.”



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