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Leadership insights


Leadership in today’s world means being versatile, resilient, and mindful of differences—whether they are cultural, geographical, or political. Now, international exchanges are part of the norm, from collegial interaction to hiring and staffing of foreign nationals. To navigate these encounters, nurses can ask themselves, “How does my awareness of international differences show up in dialogue or business transactions? How do my diplomacy skills move into action as I converse with colleagues from different countries?”

This spring, the American Nurses Association (ANA), American Nurses Credentialing Center, and King Faisal Specialist Hospital and Research Centre (KFSHRC) in Jeddah, Saudi Arabia, cohosted an International Conference on Nursing Excellence. The attendees shared a common language around nursing excellence, based on KFSHRC’s designation as the first Magnet®-recognized hospital in both Saudi Arabia and the Gulf Region, along with English as a primary language.

During that time, Sandra Lovering, DHSc, RN, MBS, BScN, CTN-A, chief nursing officer at KFSHRC, navigated international diplomacy among her nursing staff in a masterful way. ANA interviewed Lovering to gain insight.

To set the stage, please share a bit of your background.

I grew up in Canada and trained and practiced nursing for 10 years in Canada and the United States before moving to New Zealand for my first international and cultural transition. From there I moved to Saudi Arabia, where I have been practicing for 22 years. I have become acculturated to the Saudi way.

What was your biggest challenge taking on a CNO role in an international hospital?

Translating my international experience from Western healthcare contexts (Canada, United States, New Ze­a­land) to the local context was most challenging. Often, one is hired to bring Western standards to a hospital, but to be successful, you need to be able to blend different perspectives. The Western approach to leadership is individualistic and goal-focused; working in the Gulf region, I have become relationship-focused, which is a very different leadership style.

What lessons would you share with colleagues who are considering an international leadership position?

You need to have a global mindset about nursing and professional issues in order to be successful. You must embrace respect: Listen intently to the person with whom you are interacting and engage to understand their perspective. Nursing offers different perspectives depending on training, experience, and of course, the culture in which you are working. Whatever your path or opportunity, accept that you will be changed through your international experience.

What leadership competencies are required for international work?

Self-awareness, cultural intelligence, and a strong ability to embrace differences are critical to success. One needs to lead with humility, be open to adapting his or her own beliefs, and listen intently to learn and understand what others are communicating and what they need. Key personal attributes include resilience, resourcefulness, optimism, authenticity, and passion about nursing. Needless to say, you must also be able to forge multiple relationships within systems and have an ability to navigate through complexity and contradictions.

What has been your greatest accomplishment while at KFSHRC?

Achieving Magnet designation in 2013 and development and implementation of the “Crescent of Care” nursing model (See crescentofcare.com.) My doctoral research involved the values and beliefs of Arab Muslim nurses on health, illness, and healing and how they affected patient care. This heightened my awareness and understanding of the unique cultural needs of patients and their families in a hospital setting and allowed me to design the model.

What do you want your legacy at KFSHRC to be?

With the incredibly diverse mix of nurses in our facility—from the Philippines, Saudi Arabia, Europe, India, Malaysia, Jordan, and across South Africa—excellence
in nursing care can be achieved in the Middle East.

Donna Grande is vice president of products and services at the American Nurses Association.

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