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Creating a career legacy map to help assure meaningfulwork in nursing

Pamela S. Hinds, PhD, RN, FAANa,b,c,d,*, Dorienda R. Britton, BSa,c,Lael Coleman, BAa,c, Eileen Engh, MSN, RN-BC, CPNa,c,

Tina Kunze Humbel, MSN/MHA, RN-BC, CPN, CCRNa,c, Susan Keller, BS, MLS, MSa,c,d,Katherine Patterson Kelly, PhD, RNa,c,d, Johanna Menard, BSN, RN, CPNa,c,

Marlene A. Lee, MSN, RNa,c,e,Renee Roberts-Turner, DHA, MSN, RN, NEBC, CPHQc,f,

Dory Walczak, MA, MSHI, RN, NE-BC, CPHQa,c

aDepartment of Nursing Research and Quality OutcomesbCenter for Translational Science

cChildren’s National Health SystemsdThe George Washington University

eThe Clinical and Translational Science Institute at Children’s NationalfDepartment of Professional Practice and Magnet

a r t i c l e i n f o

Article history:Received 16 November 2013Revised 15 July 2014Accepted 4 August 2014Available online 8 August 2014

Keywords:Career guidance toolCareer legacy mapLegacy planningMeaningful work

* Corresponding author: Pamela S. Hinds, 11E-mail address: pshinds@childrensnation

0029-6554/$ - see front matter � 2015 Elsevihttp://dx.doi.org/10.1016/j.outlook.2014.08.00

a b s t r a c t

When nurses declare a professional legacy (or what they intend to be better inhealth care because of their efforts), they are likely to maintain a focus onachieving their legacy and to experience meaning in the process. We depict thelegacy and involved steps in creating a legacy map, which is a concrete guideforward to intended career outcomes. Informed by the “meaningful work”literature, we describe a legacy map, its function, the process to create one, andthe application of a legacy map to guide careers. We also describe an admin-istrative benefit of the legacy mapdthe map can be used by team leaders andmembers to secure needed resources and opportunities to support the desiredlegacy of team members. Legacy mapping can be a self-use career guidancetool for nurses and other health care professionals or a tool that links thecareer efforts of a team member with the career support efforts of a teamleader.

Cite this article: Hinds, P. S., Britton, D. R., Coleman, L., Engh, E., Humbel, T. K., Keller, S., Kelly, K. P.,

Menard, J., Lee, M. A., Roberts-Turner, R., &Walczak, D. (2015, APRIL). Creating a career legacymap to help

assure meaningful work in nursing. Nursing Outlook, 63(2), 211-218. http://dx.doi.org/10.1016/

j.outlook.2014.08.002.

“Efforts and courage are not enough without purpose and

Individuals who choose careers in nursing are direction.”

dJohn F. Kennedy

September 17, 1960 (The American Presidency Proj-ect; http://www.presidency.ucsb.edu/ws/?pid¼74076)

1 Michigan Avenue, NW,al.org (P.S. Hinds).

er Inc. All rights reserved2

commonly motivated by a desire to help othersthrough improved clinical care, care systems, and careoutcomes (Donner & Wheeler, 2001; Henry & Henry,2005). The motivation and the intended end points ofcare improvements represent a career legacy or a

Children’s National Health Systems, Washington, DC 20010.

.

Nur s Out l o o k 6 3 ( 2 0 1 5 ) 2 1 1e 2 1 8212

formal declaring of what will be better in health care asa result of planned steps to create or contribute to thedesired improvements (Hinds et al., 2013). Together,the declared legacy and the identified steps to achievethe legacy comprise a legacy map. The map is adepiction of the declared legacy and includes a planthat serves as a guide forward with measureable met-rics to the desired improvements. In this way, legacymapping in nursing is done with a sense of purposeand intentionality to contribute to the well-being ofothers through purposeful and meaningful workengagement. We have created, implemented, andrefined a process to create the legacy map and its usethat serves both motivational and practical purposes.We describe here the process, its use, and its outcomes.We acknowledge that our use of theword legacy differsfrom its more common usage of a bequest or gift givenfrom a predecessor. We use it here to mean the nurses’plan to contribute knowledge, practice changes, orother aspects of health care to benefit those whoreceive nursing care.

Background

There are two important and distinct discussions in theprofessional literature regarding career development,one focused primarily on achieving work goals and theother on achieving work meaning. London (1993) de-scribes the individual’s realism and clarity of careergoals including the ability to achieve the goals. Messmer(2003) and Manson (2009) define career success as goalaccomplishment or achievement of an objective andcareer persistence achieved by overcoming goal chal-lenges. Related literature examines the correlates tocareer clarity and decision making with particularemphasis on career self-efficacy and decision-makinganxiety (greater career self-efficacy being associatedwith lower decision-making anxiety; Niles & Sowa1992) and proactive career self-management (i.e., an in-dividual setting goals anddeveloping relevant skillswithless reliance on employers; Strauss, Griffin, & Parker,2012). In this literature, career mapping is a tool used toengageprofessionals (nurses) indevelopinga career goalsuchasachievingpromotionandspecifying incrementalsteps (Shermont, Krepcio, & Murphy, 2009). An institu-tional approach to foster goal accomplishment innursing is the use of career or clinical ladders. The lad-ders are comprised of levels of activities selected by theinstitution as meriting recognition financially and bytitling to represent career advancement. The ladderstend to be for nurses in direct care and not nursingleadership (Adeniran, Bhattacharya, & Adeniran, 2012;Buchan, 1999; Donley & Flaherty, 2008). Certainly, thisliterature with its emphasis on goal achievement ishelpful for career development, but it risks being insuf-ficient if the more humanistic values of meaning, pur-pose, and professional fulfillment are not considered.

Lieff (2009) describes the pursuit ofmeaningful workas part of effective career decision making in academicmedicine and specifically addresses the importance offeeling effective, creative, and balanced in a career.Emphasis is placed on the importance of achievingself-realization or authenticity through a meaningfulcareer (Brown & Gundermann, 2006; Svejenova, 2005)and the benefits to an organization when employeesfindmeaning in their work (i.e., greater commitment tothe setting, lower intentions to leave, and higher jobsatisfaction; Duffy, Bott, Allan, Kik, & Torrey, 2012).One segment of this discussion, the constructivist-social-constructionist perspective, gives far greateremphasis to work meaning by viewing careers as ve-hicles for individuals to live personally meaningfullives that contribute to improved social conditions forothers (Hartung & Tabler, 2013).

The work meaning literature also speaks to higher-order goals reflecting purposefulness (described ashaving intentionalityanddirectedness toworkbehavior)and the experience of meaningfulness in work (or thesignificance to an individual of their work efforts). Morepointedly and of particular relevance to nursing, workmeaning includes the intention of making a positivedifference in the lives of others (Barrick, Mount, & Li,2013; Grant, 2007). These higher-order goals are theo-rized to be more enduring than goals specific toachieving a certain role or career opportunity becausethey are causally linked to a sense of professional well-being. In nursing, such goals are helpful to all butconsidered to be critical to retainingmidcareer nurses inthe nursing discipline (Donner &Wheeler, 2001).

Importantly, relationships are key to individualsfinding work meaning; the relationships can be withpeers, supervisors, or those who benefit from workefforts such as patients and their families (Grant, 2007).McNeese-Smith and Van Servellen (2000) specificallyrecommend that career planning between nurses andtheir employing organizations occur to prevent disen-gagement of nurses from their work, less commitment,and lower job satisfaction. Lieff (2009) recommendsspecific exercises to assist individuals in identifyingmeaningful work. The exercises include writing a briefautobiography that emphasizes values linked to careersuccess, developing a list of personal values for use incareer decision making, reflecting on peak experiencesat work, and purposefully examining the match be-tween personal and work values. Similarly, othersrecommend self-discovery workshops for nurses thatare instructive regarding personal reflection as a wayto renew career commitment (Donner &Wheeler, 2001;Price, 1998). Reflection is inherent to the process oflegacy mapping.

Legacy planning and legacy mapping incorporatethe aspects of the career goal planning literature butadditionally include career meaning and purpose,which emphasize a career that both “gives back” toothers and satisfies self. Legacy planning and mappingfacilitate an interactive process with others whocommit to supporting the declared legacy, thus

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creating a shared experience. Although a legacy can begiven without awareness or intent, it can be plannedand made explicit with a legacy map.

Achieving a desired role or a promotion is a notablecareer metric but may not result in the betterment ofothers. A career legacy, on the other hand, is fullyintended to better the conditions, experiences, andoutcomes of others. A career legacy in nursing isintended to promote the health of individuals, families,systems, and nations. In this article, we describe thelegacy mapping process that purposefully gives pri-mary emphasis to career contributions that aremeaningful for the nurses who engage in this process.

Creating a Legacy Map

At the beginning of the process, the mapmaker an-swers the following questions:

1. What do you want to be better in nursing because ofyou and your efforts?

2. What would you like best to be known for by others?

The answers to these questions constitute thedeclared legacy; the mapmaker can declare one ormore legacies. The declared legacy is placed in a box atthe far right side of a blank screen or paper. Themapping process continues with a query similar to“what have you done to date or have in process thatwill in positive ways directly or indirectly contribute toyour legacy?” The individual activities are placed onthe far left side of the screen or paper. The mappingcontinues now inmore detail with queries about “whatneeds to happen next to move this activity on the leftcloser to your legacy?” The responses represent inter-mediate and future steps and are placed into boxes inlocations near the middle of the screen or paper.

An additional part of the legacy map is labeled“other” and contains the list of career activities thatcompetewith efforts to positively influence the declaredlegacy. A careful examination of the completed list ofcompeting activities is conducted to identify if one ormore activities could be ended, handed off to anotherpersonwho could benefit from assuming the activity, ordone differently so that it would be less timeconsuming. Certainly, some of these activities may beinherent in the current role and thus cannot be ended,but theremay be otherways to complete these activitiesnot previously considered. A step-by-step guide tocreating a legacy map is in the insert.

A skeleton template of a legacy map reflecting thecomponents of a declared legacy, current activities,future planned steps to approximate or achieve thelegacy, and the section for “other” activities is depictedin Figure 1. A map can be modified as needed (i.e.,changing circumstances, availability of new and rele-vant technologies and knowledge, and access to newopportunities) and is recommended to be updated at

least annually for purposes of individual career deci-sion making and for annual review purposes involvingindividual team members with team leaders.

To be a legacy map, the depiction needs to be an ac-curate and honest representation of (a) what is impor-tant to the individual creating the map and (b) thecontributions the individual is now giving and plans tocontribute in the future to the legacy.Creating the legacymap involves an interactive process that tends to beinitially between a team leader (who is in a position tosupport the declared legacy in instrumental andencouraging ways) and the team member who iscreating the map. The mutuality of this process en-hances the commitment to the declared legacy of boththe teamleaderandmember.Theprocessof creating themapreliesstronglyonfocusedqueriesabout current andplanned future stepsand listening to the responses fromthe teammember toensure that eachmapcomponent isdefined sufficiently and is measureable. Drawing themap is concurrent to the dialogue that purposefully in-vites reflective engagement of the teammember.

Individual Team Member Use of the LegacyMap

Individuals who have created legacy maps report thatlimiting the map to a single page enforces precisionand concise descriptions of each component that helpin articulating the declared legacy to others. Addi-tionally, the specified linkages between current andplanned actions toward achieving the legacy directsthe individual team member’s attention to the impor-tance of the actions that will move efforts closer to thedeclared legacy. At the same time, the map directlycalls attention to the activities that compete withachieving the legacy. The latter awareness becomes aclear basis for avoiding involvement in activities thatdilute legacy efforts. Self-review or review with one ormore colleagues in the samework setting can also helpto ensure that there is an alignment of the legacy andits related steps with the priorities of the work setting.

The map is a visual aid that quickly conveys the cur-rent statusof legacy effortsandwhatneeds tooccurnextto advance efforts closer to the legacy.Maps can range indetail (Figures 2e4). An example of a legacy map thathelped a teammember recognize competing activities isdepicted in Figure 3. This teammember used themap toeliminate certain professional activities that did notalign with her desired legacy and then replaced thosewith activities that directly contributed to her legacy.

The legacymap has also been useful in helping teammembers explain the focus of their work to others. Abenefit of the visual nature of the map is the readyrepresentation of progression toward the legacy and aclear reminder of relevant and related projects now inplace. The depiction can also help individuals recog-nize new opportunities that are quite relevant to theirlegacy. An additional benefit of the visual nature of the

Figure 1 e Template of a legacy map.

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map is that it can help guide future connections withothers who could support the efforts to achieve thelegacy. Finally, the map captures and conveys the in-dividual’s past achievements and steps taken, currentefforts, and future aspirations.

Team Reviews of Individual Team MemberLegacy Maps

With agreement from all team members, legacy mapscan be shared with each other. In our experience, asindividuals presented their maps and offered narrativeto support the meaning of the declared legacy and theplanned activities, theywere able to clarify the intentionof map components. The process also engaged other

team members in their colleague’s legacy aspirations.Discussion about possible career junctures and howthey might alter the map also occurred with teamsharing of individual teammember’s maps. The longer-term benefits of sharing maps with the team includedteam members’ recognition of opportunities for eachother that would support the declared legacies or theidentified contributing activities and ongoing mutualsupport related to desired career contributions.

Team Leader/Team Member Use of theLegacy Map

The process of creating and using the map immedi-ately engages both the team leader and team member

Legacy MapQuality Outcome

Team member

Nursing Quality Fellowship

Integrate the importance of

quality outcomes to drive and lead change at the

bedside to improve care and the

pa ent/family experience

CPQH cer fica onTeam Leader for Quality Project

Ini a ve

Team Lead for Magnet Narra ve

Faculty member for Nursing Quality

Fellowship

Write manuscript for Pathway Project and

disseminate

Co-chair a nursing shared leadership

council

Present at Central Nursing

Orienta on

Consult on councils directly ed into a nursing quality ini a ve

Represent the Nursing Quality Department at

various levels within the organiza on

Podium presenta on at a

na onal conference

Figure 2 e Example of a minimally detailed legacy map.

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in what matters to the teammember and in the plan tohelp advance career aspirations closer to the declaredlegacy. We have used the legacy map on a quarterlybasis tomake certain that themap is guiding decisions,assignments, and opportunities. We also use the mapduring the formal annual performance review so thatthe map directly influences the goals that are devel-oped for the new performance period. An example ofthis use was a team member’s declared legacy to pro-mote nurse satisfaction in the care system with thenursing role. Several strategies were jointly identifiedbetween the leader and member, and steps and re-sources were put in place to support the plannedstrategies. One of the strategies was to move into ahigher-level leadership role to more directly influencenurse satisfaction. Graduated activities and opportu-nities (i.e., leading committees within one discipline,leading projects that involved multiple disciplines,providing verbal reports to hospital leadership, andleading multisite projects) were initiated and contrib-uted to this nurse being immediately nominated tomove into the desired leadership role when it becameavailable (Figure 4).

Assessing the Experience of Legacy Mapping

To assess the individual experience of creating, using,and sharing legacy maps, members of our departmentwere asked to respond to two open-ended questions.At the time of completing the questions, each depart-mental member had used legacy mapping for 1 to4 years, and 9 of 10 members responded to bothquestions. The two questions and their major themes

(coded using a qualitative approach to key phrases)were as follows:

1. Please describe your personal experience (thoughts,emotions, behaviors) when you interact with yourlegacy map.a. Feeling challenged: initial reactions to the

experience included discomfort secondary toinexperience of being asked about careermeaning, fear of inadequate progress toward alegacy, and others judging the declared legacy.

b. Having an opportunity to reflect: a recognition ofhaving a chance to consider what is meaningfuland important to self in terms of a career.

c. Creating a new focus: choosing a direction thathad not been firmly identified previously andrecognizing which current activities do not addto this chosen direction.

2. Please describe the impact on you (use, outcomes,change at any level of thought, feeling, or percep-tion) of creating and/or using your legacy map.a. Filtering out: experiencing a carefully thought-

out basis for not engaging in certain activitiesthat previously would have been almost auto-matically accepted for involvement and beingable to offer this explanation to others makingrequests.

b. Being pleasantly surprised: seeing advancesmade toward the declared legacy and feelingsatisfaction or pride in that.

c. Using the map to help others: finding that theprocess and product of declaring a legacy isuseful to individuals at key points in their career.

Figure 3 e Example of a map that helped a nurse identify her involvement in multiple activities that competedwith her legacy. Shadow boxes are activities that are completed. White text boxes are activities in process.Text boxes that are not outlined are ideas in development. Solid lines indicate direct linkage to declaredlegacy. Dotted lines indicate indirect linkages.

Nur s Out l o o k 6 3 ( 2 0 1 5 ) 2 1 1e 2 1 8216

d. Linking goals and performance metrics to themap: purposefully creating connections amongrole indices with steps needed to move closer toachieving the declared legacy.

Challenges in the Legacy Mapping Process

One challenge to creating the map of the individual’strue meaning is creating a map that includes activ-ities because they are believed by the individual teammember to be important to the team leader. Leadersneed to anticipate this possibility and speak to theirsincere interest in knowing the desired legacy of eachteam member. Additionally, using the legacy mapcan be disconcerting to the team member at timesbecause it does bring to the surface serious questionsregarding professional choices and decisions andprogress toward the declared legacy. Ensuring anunbiased interaction during the mapping process is

very important to the success of the legacy mappingfor the individual team member. Also, an individualteam member’s efforts to sustain a focus on the leg-acy can be challenging if the member’s access toessential resources is dependent on one team leaderwho values the legacy, but the legacy is not consis-tent with the priorities of the greater work setting.Finally, we acknowledge that this description of leg-acy mapping and meaningful work does not incor-porate our early work with nurses at the point ofdirect care or with nursing leaders, and this use oflegacy mapping will be important to formally assessin the near future.

Conclusion

Living a career of purposefulness and intentionalitycan sustain long-term efforts in nursing directed atmaking a difference to benefit the lives of others.

Figure 4 e Example of a legacy map that contributed to an individual moving into a new leadership role.

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Declaring a career of purposefulness through alegacy map and its associated processes will assistnurses to achieve what is of most meaning to themin their career. Legacy mapping is one tool to assistin achieving career higher-order goals and to do sowith meaning fully reflected. Certainly, as with allmaps, there are alternate ways to complete ajourney, but the legacy map can guide nurses towardthe declared destination and a journey of muchmeaning. A declared legacy is futuristic, and com-plete achievement of the legacy may not be possible,but the process of attempting the legacy will verylikely be one of personal and professional meaning.

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