Health Care Reform : A Proactive Stance On Healthcare

“Nursing is informed caring for the well-being of others” (Swanson, 1993, p. 352). Kristen Swanson’s relationship-based caring theory encompasses maintaining belief, knowing, being with, doing for, and enabling. Nursing is a profession with vast opportunities for growth and development. Each nurse has his or her individual passions; mine reside within obstetrics, women’s health, and nursing leadership. Nurse leaders play an integral role in the success of healthcare organizations. Nurse leaders shape the roles of nurses within their organizations. Nurse leaders seek methods to improve patient care. They also use innovation to gain efficiencies in care delivery and decrease healthcare cost. Many nurse leaders have an ultimate goal to aspire to be a chief nursing officer in a healthcare

Effective communication is essential for a nurse in a leadership position. If a nurse is not able to convey or transfer pertinent information to other team members or clients, conflict or problems can arise. A nurse is able to effectively communicate through creating synergy, establishing a purpose or goal, actively listening, being truthful, and being responsible. When a nurse leader is able to successfully communicate, patient safety increases and medical errors decrease which leads to a higher percentage of positive patient outcomes. Effective communication fosters positive nurse-patient and nurse-team member relationships.

Nurse leaders play a vital role in establishing standards and leading organizational change. The effects of the Affordable care Act (ACA) on the healthcare industry is characterized by change (Delmatoff & Lazarus, 2014). Given this ACA paradigm transformation, I believe today’s nursing leaders must adapt quickly and assist new leaders to develop the skills necessary to envision and evaluate new healthcare delivery systems. According to Chism (2009), the roles of the doctor of nursing practice (DNP) prepared nurse graduates may be incorporated to meet the transformation of today’s contemporary healthcare. After reading the assigned material, I gained confidence that the DNP program will prepare me for eligible leadership roles within the healthcare industry.

The Health Care System 's purpose is to meet the physical and mental health needs of the communities in which they serve, these systems operate using people working within heal care facilities as well as other health delivery resources. One group of individual that help with facility operations are nursing administrators. Nursing Administrators contribute in managing along with directing the nursing care delivery system. Their leadership style, characteristics, communication strategies, including the way that they negotiate as well as manage conflicts can determine the quality of the healthcare services treat the facility provide as well as help to develop a set of guidelines to standardize the type and quality of the nursing services. (Cipriano, 2011) Together the Nurse Mangers work toward the same goals along with guiding nurses in their practice and contribute to the facilities successes. (Frankel, 2011) The nursing leaders are advocates who directly affect the quality of the nursing care along with also having a positive impact on healthcare through leadership.

Slide 1: The expectations of nurses today are higher than ever with goals such as achieving top percentiles in nursing and patient satisfaction, to being among the top leaders in quality outcomes, and to build productive work relationships and environments. Nursing leaders serve as the primary link between staff, physicians, and the community. They are expected to be innovative, highly skilled, possess a certain degree of nursing knowledge, and produce qualified individuals to care for the growing population. According to Lorber, Treven, and Mumel (2016) “nursing leadership is pivotal because nurses represent the most extensive discipline in health care”. Because of this growing need for diversity in leadership and my background in the military, I decided to focus on the MSN Executive Track at Chamberlain College of Nursing.

Now, the graduate level nurse’s leadership attributes have been described in scholarly sources. Based on the documents of the American Association of College of Nursing (AACN) (2013), essentials of graduate nursing must be skilled in organizational and systems leadership role. Specifically, they are supposed to assume leadership roles in quality improvement and patient safety initiatives while working in the interprofessional team context. APN must use communication in an effective way, with regards to speaking, scholarly writing, and group interaction. Nurse leaders should also demonstrate the working knowledge of the current healthcare system and its essential components, including delivery and payment models, sites of care, roles of various stakeholders in the process of care delivery (AACN, 2013).

Every day, a set team of nurses and nursing managers set out to ensure the health and well-being of their patients. To achieve this goal, a nurse manager must adhere to a specific style of nursing leadership. There are many different styles of leadership in the healthcare field. Bass and Barnes (1985) stated that the two most common are transformational and transactional (as cited in Frankel, 2008, p.24). This paper will define leadership, the two different styles, how each are executed, as well as pros and cons of each.

The American Association of Colleges of Nursing has identified nine essentials that are incorporated into master’s nursing programs to help direct the practice of advanced practice nurses (APN’s). Essential II outlines how an APN can utilize organizational and systems leadership to promote safer and more cost effective care. By incorporating effective leadership skills, APN’s can help transform healthcare and make quality improvements for the patient, the institution, and the community. According to the American Association of College of Nursing (2011), an effective leader assumes and applies “the skills of communication, collaboration, negotiation, delegation, and coordination” (p. 11). APN’s must be able to establish and maintain a healthy

Not all nurses go into the profession with leadership ideas. The nursing profession must produce leaders throughout the health care system. Leaders must function as workers, and administrators with leadership qualities, while still meeting their budgets and running effective units with high functioning and happy staff members. They need to trouble shoot necessary and work with the medical faculty while pleasing their staff and the administers.

There are many skills, traits, and behaviors one must possess in order to be an effective leader. The American Organization of Nurse Executives (AONE) has compiled a list of competencies and skills that nurse leaders should be proficient in. The five competency domains identified by AONE (2011) are “communication and relationship building, knowledge of health care environment, leadership skills, professionalism, and business skills” (p. 3). The competency domain I believe is essential for one to possess in order to be an effective executive nurse leader is communication and relationship building. The competencies AONE (2011) listed under the domain communication and relationship building are “effective communication, relationship management, influence of behavior, ability to work with diversity, shared decision-making, community involvement, medical staff relationship, and academic relationships” (p.3). I will discuss how Tom (nurse manager of a psychiatric unit) did not meet these specific characteristics under that domain.

In the increasingly complex, ever changing environment of today’s healthcare, effective leaders are essential to help drive positive change resulting in increased access to care with positive outcomes for as many as possible. In its 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recognized that nurses are well positioned to play a key role in the transformation of our healthcare system in the United States (U.S.) (Institute of Medicine [IOM], 2010). In The Essentials of Doctoral Education for Advanced Nursing Practice, the American Association of Colleges of Nursing (AACN) specifically identifies organizational and systems leadership as a core competency for advanced

Leadership traits associated with nurse executives are honesty, credibility, supportiveness, visibility, and flexibility. Nurse executives analyze nursing functions and empower nurses through participatory decision making, shared governance, and employee involvement. Nurse executives share the vision and goals of the hospital and promote application of a nursing theory into the nursing care delivery system. They anticipate the future of health care and nursing and serve as monitor, role model, and preceptor to lower level management (Upeniecks, 2003). Nurse executives in the Magnet program are required to have advance practice degrees with certification in their specialty (ANCC). Understanding evidence-based management and enabling the use of evidence-based knowledge provides the nurse executive with the tools to improve patient outcomes. The transformational leader will remove barriers to improvement and encourage outcome based thinking. While nurse leaders are charged with questioning the status quo, nurse managers in the transformational approach to leadership are charged with maintaining the status quo.

Nursing leadership is also one of the very important messages of the 2010 IOM report on nursing. The IOM calls to expand opportunities for nurses to lead. It advises that nurses need to be prepared and enabled as leaders in order to advance healthcare. One of the recommendations states that “expand opportunities for nurses to lead and diffuse collaborative improvement efforts” (IOM Report, 2010). In that regards, a research article (Sherman, 2011) points out that charge nurses on frontline of acute care setting are the

In the healthcare field, nursing leaders and managers face consistent issues in their respective practices that force them to alter the way they work and the way they think. In taking on a role as a leader within the field, nursing leaders and managers also take on the role of ensuring that work within an organization runs smoothly regardless of new issues that may arise in the healthcare arena. For instance, in today's healthcare environment, the issues of nurse shortage and nurse turnover have the capacity to alter the healthcare field and many of its respective branches and organizations should these problems not be managed properly by the leaders in the field. In viewing the issue at hand and in discovering how nursing leaders and managers are expected to act, and do act, in order to approach this issues, along with pinpointing the best approach possible to aid this issue, one can better understand which leadership styles are necessary for leaders to function.

Nursing is a very complex career that at many times requires one to be a leader. Nurses can be leaders in formal roles and also on the unit during any given shift. Nursing is a career that truly tests the character and attributes of those who choose to enter this career. Leadership in nursing is vital in creating a successful environment for patients. According to Stichler (2006), “effective leadership is essential to transforming organizations into environments that are safe for both patients and staff” (p. 422). Therefore, it is vital that as new nurses start out his or her careers that they learn from great leaders who are already in the profession. There are several great leaders working in the field who have a plethora of