Mike has driven the introduction of SBNH at the Canadian Nurses Association and is the liaison between the CNA and the Partnership Grant. He co-chairs the Knowledge Mobilization Committee. Our Project Administrator Anna Adjemian spoke to Mike about his path to policy work, and the value and potential of a Strengths-Based approach for nursing and healthcare leadership in Canada. This conversation took place in late December 2021, as the Canadian healthcare system was battling the fifth wave (Omicron) with a workforce already deeply depleted by the preceding almost two years of the Covid-19 pandemic.
Anna Adjemian: Please give us a short background/summary of who you are and what you do professionally.
Michael Villeneuve: I grew up wanting to be a surgeon. I directed my education to science, and the things you do when you think you want to be a doctor. I went into a hospital to work as an orderly when I was 19, and they put me in Emergency the first day. I watched what the doctors were doing, and what the nurses were doing, and I remember having this feeling of “Oh God, I picked the wrong thing this whole time! I’m not interested in what he’s doing, I’m interested in what they’re doing.” ER nurses are a pretty tough crowd – strong and skilled. I thought, I’d like to be like that. I never looked back.
I went into nursing and worked the first 20 years in clinical, around neurosurgery and trauma, in hospitals mostly. I worked for a time in a First Nation and then in a research unit, to try some different things. I was a manager for 5 years. In 2000, I was offered an opportunity to work in the National Chief Nursing Office of the Federal Government. My former boss, Judith Shamian, was federal chief nurse at the time. She asked me if I wanted to work with her, and I was in Ottawa two weeks later, in the Office of Nursing Policy. That was one of my great lessons – the leap of faith. If somebody smart asks you to do something, they already think you can – even if you can’t see it. I did it, and here we are almost 22 years later: I’ve been working in policy roles this whole time. I’ve developed a knowledge of public policy, nursing policy, government, governance, and leadership. I was appointed the role of CEO of the Canadian Nurses Association in June of 2017. Top nursing job in the country, in my view, and absolutely the best job of my career. You get to serve your country on a micro level in a hospital, but it’s different going into national offices, where you see the expansive view of the country – across the time zones, the different kinds of people, Indigenous history, and so on. It’s a privilege to be involved in really exciting work. The piece that I will miss the most – it is the greatest privilege – is getting to talk to such interesting people: people in government, senators, MPs… I got to go to other countries, meet so many people. It’s just such a privilege.
Why did you get involved with this project?
I was introduced to Laurie [Gottlieb] through Judith Shamian. She and Bruce [Gottlieb] came down for a day to CNA and talked about SBNH. I knew about Strengths-Based Nursing and Healthcare, but for me it was just a theory from another university. But when they came and talked about [SBNH], it made such intuitive sense to me to apply it to leadership. We are struggling so much in this country with nursing leadership, and it provides tools and a way of organizing your thinking about it – it provides a place to start. Knowing that I wanted CNA to launch the Canadian Academy of Nursing, which came more than a year later, it seemed like a really good fit. At the time I thought maybe Strengths-Based Nursing and Healthcare Leadership would be the framework that underpins the Academy, and our way of thinking about leadership. We’re not there yet, and that’s okay. It’s being introduced, being talked about; other people will need to buy in. Sister Elizabeth Davis has said that a vision isn’t a vision if it’s only held by one person – it must be held by a community. We appointed Laurie as our Visiting Professor of Nursing Leadership. That relationship of being around a scholar, versus a user of scholarly work like me, was helpful. And some of [joining the partnership] was frankly the fun of working with people I care about. Part of it was just – I like them.
What does SBNH mean to you?
SBNH sort of flips our historical approach – originally to clinical practice, but also to leading teams – which is to look for the problem. What will go wrong tonight? I did a lot of that. In our training it was very popular to write a care plan of many pages. We had to come up with nursing diagnoses, to find the three potential problems for each patient. Hospitalized critical care patients have a lot of problems. But I can remember situations – for instance, a young guy in for two nights having a back operation – where there were a lot of strengths. He’s young, he’s strong, he’s going to be out of here in 3 weeks; what does he need to get him out of here? We approach this often with leadership and management too.
I manage an organization now, and I don’t look at it every day and say, “What’s going to go wrong?” But rather “This is a very strong team. How can we help them get this piece done?” It’s a different way of being. As a manager in the clinical setting, there were times when I’d look at the schedule and I’d be a little concerned about the group of people that were on a certain shift and think, this isn’t going to go well. You can’t be naïve to weakness or potential problems. But the SBNH approach doesn’t mean you ignore danger signals: it gives a frame of reference, how to identify and groom and bolster the best. It’s risk mitigation. Some things don’t make any difference if they go wrong. Who cares if we’re a day late putting out an article? But if you’re a day late fixing an airway – that’s different. You have to understand the landscape in front of you, the seriousness of the risk, what will happen if you do or don’t act. It’s the same with leadership. Who’s on? Who’s in charge? If I see that everyone is crying because they’re so overwhelmed, which has happened under my leadership, then I need to turn the ship a different way. These are strong people, and they’re not behaving strongly, they’re crushed – what do we put in place to support them? There’s something different in inherently looking for the positive and the good versus a very industrial approach, lining people up and figuring out where they could go wrong.
What does this project mean to you/what do you hope to see come out of your work on this project?
SBNH-L is the only strongly nurse-led leadership model I’ve seen beyond the framework that underpins the Dorothy Wylie Health Leaders Institute. It brings the nursing lens. A lot of our theoretical work, in all disciplines, is so remote, in the minds of researchers and scientists. Whereas SBNH was introduced early on to nurses at the bedside, and you could see right away that it was applicable. It can be used by real people. It gives me hope that we could have a model that’s a Canadian new standard in nursing leadership.
I hope that we continue as a team to do the best we can to simplify the message away from the theory. Make it very real, like the [Pilot Program, Day in the Life] videos, the story-sharing; get the word out across Canada. We’ve got a serious leadership problem here that we have to resolve. How could this thinking dovetail with the work of the College of Health Leaders, the LEADS framework, and the people who run Masters programs? How do we get it socialized, as a social movement?
We’re so completely seized by the nursing shortage – we’re struggling with what’s going to help the healthcare system. We’re at a point now as we do this interview that Stanton Hospital, for example, in Yellowknife, has a 22% vacancy. Almost a quarter of the nurses gone. There are so many underpinning, fundamental workplace problems for which we haven’t implemented change. The problems feel intractable. They are not going to be undone fast and easy. We’re overwhelmed with the mental health deterioration of nurses and the fact that they’re just walking out. In this context, SBNH is a positive thing; if leaders have some training in it, can see strength and build strength – the attitude of the leader who is informed by SBNH will be helpful.