By Debra Wood, RN, contributor
May 6, 2014 - America’s 3 million nurses are celebrating their leadership roles in health care during the 2014 National Nurses Week, from May 6-12. The week will conclude on the birthday of Florence Nightingale, a recognized leader in the profession.
Beverly Malone, PhD, RN, FAAN, called seeing fellow nurses step up one of her great joys.
Not every nurse will become an international trailblazer for the profession, but every nurse has an opportunity to promote quality patient care and resolve emerging issues within the profession--that shows leadership. And that’s why this year’s theme, selected by the American Nurses Association, is Nurses Leading the Way.
“I am so delighted this is the theme,” said Beverly Malone, PhD, RN, FAAN, CEO of the National League for Nursing. She explained that there are many different ways nurses lead: from navigating patients from the bedside to back home, and changing policies within their organizations to serving on boards and shaping policy.
Debra L. Fowler, PhD, MBA, RN, CNE, said nurses must lead to influence health care and achieve the best patient outcomes.
“With more than 3 million nurses on the frontlines of health care, we are critical to improving our nation’s health and are providing leadership to address many challenges including the increasing numbers of persons with chronic disease conditions and improving health care outcomes while decreasing cost,” added Debra L. Fowler, PhD, MBA, RN, CNE, assistant professor of nursing systems and track director of MSN in nursing leadership and administration at the University of Texas Health Science Center at Houston School of Nursing.
Nurses provide leadership to their patients by assisting them to improve their individual health and lead their nurse colleagues by using evidence-based practice, Fowler pointed out.
Nurses leading across the spectrum
“We need to be leaders in evidence-based practice and health care transformation,” said Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, dean and professor in the college of nursing and professor of pediatrics and psychiatry in the college of medicine at The Ohio State University in Columbus. “In particular, we need to be leading the health promotion and prevention paradigm throughout the United States.”
Tracey Melhuish, MSN, RN, CCRN, said by effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields, with nurses leading the way.
Evidence supports what nurses should be doing to improve health care quality and patient outcomes, but a time lag exists between the production of research findings and implementation in the real world, Melnyk explained. She advises nurses to “slay sacred cows” and put a sense of urgency on change.
At Holy Cross Hospital in Fort Lauderdale, nurses are also leading the way in clinical transformation, said Tracey Melhuish, MSN, RN, CCRN, clinical practice specialist.
“Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization,” Melhuish said. “It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and information technology implementation.”
Taren Ruggiero, MSN, RN, interim CNO at Holy Cross, added, “With healthcare reform, we are transitioning from a heavy emphasis on taking care of sick patients and moving to seeking a better understanding and developing best practices on ways to keep our communities healthier. Nurses are impacting quality of care every day at the bedside. In addition, nurses are leading the way with preventing avoidable readmissions, which is improving quality and driving down the cost of care.”
Taren Ruggiero, MSN, RN, said nurses are leading in a variety of ways, from keeping patients healthier to improving quality and driving down the cost of care.
Ruggiero added that the movement from the inpatient setting to the outpatient setting brings challenges. Therefore, the role of the nurse in teaching complex procedures and coaching on early signs of potential complications is critical in helping the patient and family be better prepared.
“Nurses provide a unique perspective of health care and are educated to help individuals and communities achieve their highest possible level of health,” Fowler said. “We are expert communicators and collaborators. Nurses are especially well suited to improve our nation’s access to high-quality, affordable care. In order to influence health care and achieve the highest possible health outcomes, nurses must be leaders in hospitals, public health settings, local and national organizations, universities, and policymaking boards.”
Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing and director of the Future of Nursing: Campaign for Action at the Robert Wood Johnson Foundation in Princeton, N.J., is proud of the gains nurses at high levels have achieved, but emphasized all nurses have an opportunity to lead.
“Instead of ignoring something on your unit or doing work-arounds, go to the chief nursing officer or write an email about why something should be changed,” Hassmiller said. “Nurses need to think more about what they can do, rather than what they cannot do.”
Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, advises nurses to “slay sacred cows” and put a sense of urgency on change.
Nurses can begin by becoming agents of change where they work in creating environments and cultures of wellness in their units and organizations, Melnyk suggested. They also can look beyond those doors.
“Nurse must be more present and at the table in national forums related to health care,” Melnyk said.
Nurses serving at higher levels
“Nurses hold key leadership positions in health care organizations, including the CEO role in many large health care systems,” Fowler said. “They serve on boards, such as the Red Cross and American Heart Association. Additionally, they have major national leadership roles; for example, the administrator for the Centers for Medicare & Medicaid Services is a nurse.”
Yet nurses often are not present during health care decision making.
Susan B. Hassmiller, PhD, RN, FAAN, called on all nurses to join their peers in leading.
“There is so much going on in health care, and there are many people making decisions for nurses when it comes to patient care, quality and technology,” said Hassmiller, who encourages nurses to change that dynamic by stepping up and volunteering.
Malone praised the Robert Wood Johnson Foundation’s efforts to promote nurses serving on boards.
“We have more nurses than ever before on boards, not just sitting on boards but speaking up and having the opportunity to shape the dialogue and decisions,” said Malone, emphasizing that nurses know when to lead and when to follow.
The national Campaign for Action, supported by the Robert Wood Johnson Foundation and AARP and working to implement the recommendations outlined in the Institute of Medicine’s “Future of Nursing: Leading Change, Advancing Health” report, has focused on leadership this year.
The New Jersey Action Coalition completed an analysis of where nurses serve on boards and where they could be serving. It sent a survey to members of the New Jersey Nurses Association, asking them if they would be willing to serve on a board, and the action coalition is now matching nurses to possible appointments.
In Colorado, high-level nurses in the action coalition created a monthly salon during which they review board openings and try to pair nurses to available positions.
Several action coalitions, such as the one in Virginia, are recognizing young nurse leaders, with 40 under-40 recognition programs. The California Action Coalition has developed a successful mentorship program for nursing leaders, as well.
Honing one’s leadership skills often requires mentoring.
“It’s difficult to lead without mentors,” Malone said. “I would like to thank all of the mentors for taking the time, having the vision to see something in us we didn’t see in ourselves and to move over to give us space.”
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