AMSN & MSNCB CEO Terri Hinkley Earns Doctorate, Gains Invaluable Lens to View the Future of Nursing

  • Posted on: 27 June 2019
  • By: AMSN

In May, AMSN and MSNCB CEO Terri Hinkley, EdD, MBA, BScN, RN received her Doctorate in Human and Organizational Learning from George Washington University. The Human & Organizational Learning curriculum focuses on organizational issues such as strategic change, transformational leadership, individual and group learning processes, organizational development, and global and international issues. The degree helped Hinkley to develop a more critical lens with which to see the nursing community and its issues and challenges.

“What interested me about the program at George Washington University was that it was structured with four main pillars: leadership, learning, culture, and change. You can take those constructs and apply them to whatever challenge you are facing in business or professional life,” she says. “For me, as a non-profit executive in the healthcare industry, with a true passion for nursing, I could marry my experience and commitment to the profession with the executive leadership principals, to better explore the future of nursing.”

Hinkley completed the three-year doctoral program with a dissertation that focused on a critical issue that she feels is extremely important to nurses: second victim syndrome. She used a structural equation model to measure causal relationships between psychological capital, social capital, and second victim syndrome. In other words, she was interested in understanding how an individual’s overall life outlook and social support systems combine to impact the severity of second victim syndrome experienced by a registered nurse.

Second victim syndrome occurs when a care provider experiences an unanticipated adverse patient event and becomes victimized in the sense that the provider is traumatized by the event. The provider can feel personally responsible for the patient outcome. Many nurses feel as though they have failed the patient, second guessing their clinical skills and competence. If left unchecked, it can leave the professional depressed, feeling alone and desperate. Sadly, second victim syndrome has led to death by suicide for some nurses.

“I am interested in the impact of negative affective states for nurses: burnout, compassion fatigue, moral distress and second victim syndrome. I am drawn to them, because I really want to change the experience for our nurses moving forward. I don’t want them to have such negative experiences that they drop-out, disconnect from their jobs and their patients, or turn to alcohol and drugs,” says Hinkley. “I welcome anything that brings to light the factors that contribute to these conditions, because it means we can better help to minimize them.”

Hinkley’s research found that no matter how much hope, optimism, self-efficacy or resilience you generally had, how severely – and if – you suffered from second victim syndrome depended on how people treated you, and whether people affirmed your competency as a nurse or blamed and shamed you.

“That treatment from the nurse’s social support system was clearly the important variable in my study. You need support from your unit or team, your institution, and the industry / profession to recover from an episode of second victim syndrome. All three levels of support are important to preventing such negative effects,” she says.

Hinkley says that her doctoral degree will benefit AMSN, MSNCB, and AJJ (AMSN and MSNCB’s association management agency) more broadly, because she can see things even more clearly from the nursing perspective. She can offer more ways to help nurses navigate a rapidly changing work environment, as her doctorate research prepares her to better help the AMSN and MSNCB boards and staff to think differently about what programs and services are offered to nurses by the associations.

“I wanted to focus on the environmental factors and strategic foresight. It allowed me to look at nursing through a lens of culture and change. Skillsets and experiences and backgrounds have changed from what they were for nurses decades ago. So we need to ask: How do we address that and meet new needs of the future workforce?

“We now have a five generational workforce for the first time ever: traditional, baby boomer, Gen X, Millennial, and Gen Z. That landscape alone causes disruption of support and increases misunderstandings – because each generation is so markedly different,” she says. “The Gen Zs are digital natives; they have never grown up without a smartphone. Their expectations and experiences are unique to traditionalists and baby boomers, who sometimes never fully embrace technology. Gen X-ers live-to-work, while Gen Zs want to work-to-live – that’s a very different paradigm. It means we need to think about work differently to meet both organizational and nurse needs.”

To effect change, Hinkley believes that everyone involved in the nursing community can do more to support nurses and give them the tools they need so that they can support each other. With those resources, nurses can thrive.

“I can’t express how eye-opening the doctorate program was for me. I am fulfilled knowing I will be able to apply what I have learned. I am able to look at nursing through a very special lens to study the issues affecting nurses. I know that AMSN and MSNCB will be able to meet the needs of our nurses even better as a result.”


A Reflection of Nursing Around the World

by Robin Hertel, EdS, MSN, RN, CMSRN - President, AMSN

I recently attended the International Council of Nurses Congress, a gathering of more then 5,000 nurses from over 120 countries. Discussions and poster presentations over four days involved many of the issues nurses face on a daily basis, including safe staffing, workplace safety, quality, and the healthcare model.

The central theme of the conference centered on moving beyond the focus on disease to one that is more focused on maintaining health. A key role for nurses in primary health care involves assisting patients to remain in the home as long as possible according to Elizabeth Iro, the Chief Nurse of the World Health Organization. This requires medical-surgical nurses to expand their areas of expertise to include disease prevention and the health of the community; of taking stock of where we are individually as nurses both professionally and personally; identifying our knowledge gaps and then taking action to address them.

Investing resources in the power of nursing leadership was another focus. Even though nursing makes up 70% of the healthcare workforce, only 25% of leadership roles in healthcare are held by nurses. Yet nurses are the experts in the care needs of our patients, of the quality and safety gaps that exist in the practice environment and in staffing needs. Nurses have the power to hold the politicians and the health care system accountable for investing in the leadership potential of nurses if we collectively voice our concerns and support this with data and potential solutions. As a part of the health care team, nurses and administrative staff can work collaboratively to address the issues nurses face daily such as safe staffing and protection of the nurses and support staff from acts of violence. Having a seat at the table and actively engaging in discussions and policy development allows nurses the opportunity to change the health of our communities, our nation, and our world. Having a seat at the table is vital if the nursing profession is ever to realize a positive and collaborative health care environment in which we practice to the full extent of our licensure and do so safely.

These are big issues and ones that AMSN is helping the medical-surgical nurse to address. The major focuses of AMSN’s strategic plan include providing tools to nurses to develop and maintain a healthy and safe practice environment, assisting in the professional development of medical-surgical nurses by providing education in the areas where knowledge gaps may exist and promoting the status and profile of nursing through certification as well as legislative advocacy.

Nurses, both individually and collaboratively as a profession, can truly have a positive impact because we are experts at delivering patient-centered care while maintaining quality. We have opportunities to become more involved in the areas of policy development and turning these policies into practice while keeping patient safety at the forefront. Next year has been designated the Year of the Nurse. What will you do to move your practice and the profession forward?