Leadership And The Graduate Nursing Role

The American Association of Colleges for Nurses [AACN], (2006) in 'The Essentials of Doctoral Education for Advanced Nursing Practice ' Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking, affirms "advanced nursing practice (APN) includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. APNs should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery". (p.10) Hameric, Hanson, and Tracy ( 2014) indicates that APN must assess the clinical microsystems in which they perform nursing practices, have knowledge of the medical organizations that impact their specialties, assist with establishing patient centered care reforms to enhance quality of nursing care, improve patient safety, and provide nursing indicators that evaluates nursing performance. (p.266) APNs perform leadership capabilities in four chief areas including clinical practice settings, in the nursing career, within organizations, and in healthcare politics at regional and national levels. (Hameric et al, 2014, p. 266)

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.

Nurse leaders are the background to the nursing care. Effective nurse leaders can promote a positive workforce and a healthy work place for other nurses. Workplace dynamics is an essential part of how each nurse functions. Nurses, being mentally and physically stressed, need to have support and guidance from a nurse leader to feel confident about performance. The impact of nursing leaders can be a positive and guiding force for the younger or more inexperienced nurse. Having strong relationships with solid leaders can instill values in the beginning stages of a newer nurses’ career. Gaining insight and core concepts from a more experienced leader can make a world of difference in the way a new nurse performs, provides patient care, and sets future goals for themselves. A newer nurse with a positive role model and nurse leader can model themselves to become a leader for future nurses.

In nursing, leadership does not only consist of being in a higher position but in all aspects of nursing, whether one is a staff nurse or a unit manager. A nurse must be able to lead patients, family, or a community, to a higher level of understanding in regards to the over all aspects of people’s health. However, primary degrees in general do not prepare nurses for

Leadership is a core competency in the field of advanced practice nursing (Hamric, Hanson, Tracy, & O’Grady, 2014). Graduate level nurses exercise leadership across four major spheres including nursing profession, clinical practice environments, health policy, and at the system level. This paper provides and analysis of the author’s leadership style and attributes, a description of the attributes of leadership pertaining to graduate level nurses, and a discussion of the attribute that the writer feels need development with regard to the role of an advanced practice nurse.

After taking the Leadership quiz I discovered that my leadership style is Participative. Participative leaders often ask the opinion of group members and solving problems but ultimately make the final decision. I agree with my findings and I often apply this leadership style at work. I find myself asking other coworkers their opinion on how to troubleshoot a problem. In the nursing occupation it is very important to have teamwork. Being a participative leader exemplifies teamwork. This displays that I value the opinions of my coworkers and feel that everyone should be able to make recommendations and suggestions and as a leader I can take those ideas and make a final decision. On my unit I was a charge nurse and as a charge nurse I always tried to include the recommendations of my coworkers.

Leadership at times can be a complex topic to delve into and may appear to be a simple and graspable concept for a certain few. Leadership skills are not simply acquired through position, seniority, pay scale, or the amount of titles an individual holds but is a characteristic acquired or is an innate trait for the fortunate few who possess it. Leadership can be misconstrued with management; a manager “manages” the daily operations of a company’s work while a leader envisions, influences, and empowers the individuals around them.

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.

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 may mean different things to different people, the consensus opinion of experts in this field is that leadership is using power to direct and influence activities of people to achieve set goals or targets. Nursing leadership is all about every nurse providing, facilitating and promoting the best healthcare services to client and to the public. Leadership is a shared responsibility. (CNO 2012). The nursing profession need leaders that can build the capacity of nurses through mentoring, coaching, supporting, developing the expertise and management skills of nurses to make a difference to the quality of patient care at all levels of the profession ( McIntyre & McDonald, 2014 ). At the core of every leadership either political or managerial is power and how the leader uses it. While it is practically impossible to lead without power, how the nurse leader uses this power not only determine the leadership style but also the results or outcomes of what is achieved through the process.

Hand in hand with education progression and nurses being full partners, the IOM fully expects that many more nurses will emerge as leaders.  The report proposes that leadership be embedded in nursing education to prepare nurses for this role.  It describes the importance of mentorship in helping nurses to achieve advancement, leadership and partnership.  Along with leadership roles a nursing residence or preceptorship program would be prudent to better transition nurses all the way from novice nurse into more multifaceted responsibilities and roles (The future of nursing: leading change, advancing health 2011).  What a culture change this would be from nurses who are rumored to “eat their young” to nurses who mentor and guide those around them. A culture of teamwork working towards a common goal would increase nursing retention, satisfaction and in turn produce happy nurses who make happy patients!

The Professional Performance Standard of leadership by the American Nurses Association 's Standards of Professional Nursing Practice (2010) states, “the nurse professional demonstrates leadership in the professional practice setting and the profession" (ANA, 2010). The definition of leadership in relation to the nursing profession is defined as; “Leadership refers to the ability to guide, motivate, and inspire, and to instill vision and purpose” (Ellis & Hartley, 2012). The application of leadership in the profession of nursing involves the ability for the nurse leader to “influence the beliefs, opinions, or behaviors of others and to persuade others to follow your direction” (Ellis & Hartley, 2012).

Nurse practitioners (NP) are advanced practice registered nurses (APRN) who are educated and trained to provide health promotion and maintenance through the diagnosis and treatment of acute illness and chronic condition. As a future NP, the author of this paper describes her philosophy of leadership, the leadership style which best fits on her abilities, leadership theory appropriate for her role in Family Nurse Practitioner (FNP) and how she envision her leadership evolving the next five years.