The Abc Health Care Center

“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

In today’s healthcare system, effective leadership is essential to improving and reaching organizational outcomes. A leader is someone with the ability to influence others but, an effective leader uses positive strategies to inspire employees to work towards the same goal. Leadership in nursing requires a constant effort to motivate others to become part of the organizational transformation. This can be achieved using a transformational leadership style with a focus on communication, motivation, and empowerment.

There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.

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.

Health centers have continually proven to be a worthwhile investment by delivering high quality, affordable health care. Evidence based research shows that Community Health Centers prove to be a lasting solution for disease prevention and health promotion to our medically underserved population. Additional evidence based research statistics show the following:

Hain, D., & Fleck, L. (2014). Barriers to NP Practice That Impact Healthcare Redesign. Online J Issues Nurs, 19(2). Retrieved from http://www.medscape.com/viewarticle/833516_print

The biggest need that I found for the Community South medical Center is the need of clinical staff including registered nurses, respiratory therapists, and medical technologists. “The power of the healthcare workforce can have significant strategic implications for any healthcare organization, as the workforce is composed of the front line of

Malloch, T. P.-O. (2013). Leadership in Nursing Practice: Changing the Landscape of Health Care. Burlington MA: Jones &

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

"In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) began a two-year study initiative to respond, the need to assess and transform the nursing profession."("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010).An interdisciplinary committee was put together to report the nations issues impacting health care. Recommendations were set forth by the IOM in a way to improve and restructure the nursing profession to fit the future of the medical field. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010) The recommendation from the committee starts with an action-oriented blueprint for the future of nursing also to identify matters of medical care, research, education. (AJN, American Journal of Nursing: 2010). The Affordable Healthcare ACT (ACA) of 2010 introduced new changes to United States healthcare system. These changes were the improvement of research and evidence-based practice, health awareness, prevention screenings, and community-based wellness promotion and applied. (Affordable Care Act, 2010) Before the IOM’s action-oriented blueprint nurses came up against barriers that prevented them from being able to the start to make those transformations. Today nurses have the potential to overcome obstacles by leading innovative strategies to transform nursing education, practice, and leadership. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010)

The third barrier discussed in the IOM’s Future of Nursing report was that nurses need to be full partners, with all other health care professionals, in order to redesign health care in the United States (IOM, 2010). To do this nursing education must add leadership aspects to the education programs. In doing this it will ensure that nurse are ready to actively participate and lead in decisions regarding healthcare

Formidable health care organizations, healthcare outreach facilities, healthcare partners, and dedicated health care leaders are nothing new to the Central Florida region. Central Florida has given birth to some of the best and well-known health care systems in the nation. “The region is home to several respected hospitals that are ranked in the nation’s top 100, a Level One Trauma Center, nine designated teaching hospitals and the University of Central Florida, College of Medicine” (Winter Park Memorial Hospital, 2013). Although there are several economic hardships taken place within the nation’s health care industry, Central Florida’s healthcare organizations are amid in serving the community.

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.

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.