Nurse leadership has received increasing attention since the Institute of Medicine (IOM) published The Future of Nursing: Leading Change, Advancing Health in 2010. The report recommended that the healthcare system “provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts.”
Leadership can take many forms, including frontline nursing leaders, nursing administrator leaders or nursing executive leaders. Nurse leaders also work in education and in health policy roles such as board membership.
Not all leadership is formal: a nurse who can recognize problems, speak up about them and look for solutions is a leader, regardless of their job title. Informally serving as a mentor to a new nurse is another type of leadership.
Formal leadership roles often require at least a bachelor’s degree (BSN). If you are a nurse who does not yet have a BSN, an online RN to BSN program can introduce you to leadership and management principles. Look for a program with a course in leadership and management, like the one offered in Lamar University’s online RN to BSN program. The course introduces theories of leadership and management and looks at the nurse’s role as a patient safety advocate, healthcare planner, leader and manager.
Nursing Management and Administration
Nurses who want to move into official leadership positions often start in a management position. While not all managers are good leaders, nurses with leadership skills are ideal candidates for managerial positions. Leaders have the ability to motivate those around them.
The first step into management is often as a nurse manager, which may go by titles such as nursing supervisor, head nurse or unit manager. Nurse managers are responsible for nursing practice and quality of care among frontline nurses. They act as a liaison between the healthcare facility, physician groups and the nursing staff. Nursing managers’ duties include the following:
- Supervising and recruiting nurses.
- Collaborating with doctors.
- Assisting patients and their families.
- Managing budgets.
- Overseeing paperwork such as medical records and disciplinary actions.
Sometimes, the title “nurse manager” is interchangeable with “nurse administrator”; however, some sources differentiate the two. A nurse manager is more likely to be responsible for one or more nursing units inside a healthcare organization, while a nurse administrator usually has responsibility for a group of departments, an entire hospital or several hospitals.
A nurse administrator might also fall into the category of nurse executive. Possible titles include Director of Nursing, Vice President of Nursing, Chief Nursing Executive (CNE) and Chief Nursing Officer (CNO).
The American Organization for Nursing Leadership (AONL) supports nurses as leaders in a number of ways:
- The Care Innovation and Transformation (CIT) Program is a workshop-style series of lectures, interactive exercises and training modules. These help nursing unit leaders and frontline staff improve patient care, hospital performance and employee engagement.
- The AONL Foundation for Nursing Leadership Research and Education offers programs that include annual small grants to fund nursing research projects, leadership development and the annual Nurse Researcher Award.
- Certified in Executive Nursing Practice (CENP) is for nurse leaders engaged in executive nursing practice. For nurse leaders in the nurse manager role, AONL in partnership with the American Association of Critical-Care Nurses (AACN), offers the Certified Nurse Manager and Leader (CNML) credential.
Other opportunities for nursing leadership support and training include the Campaign for Action.
Non-Management Nurse Leadership
Nurses who want to lead do not necessarily have to become managers or executives. Other leadership roles include nurse practitioner, clinical nurse specialist, staff educator, risk management specialist, quality improvement specialist, infection control specialist and nurse researcher. These roles place nurses in positions where others naturally look to them for their expertise.
According to the IOM’s report, “One new role for nurses that taps their potential as innovators is the clinical nurse leader (CNL), an advanced generalist clinician role designed to improve clinical and cost outcomes for specific groups of patients.” A CNL is responsible for coordinating care and, in some cases, actively providing direct care. The CNL consults research findings to design, implement and evaluate care plans for patients.
Nurses as Leaders on Boards
As nurses gain leadership experience, another role they can fill is board member. According to Nurse Leaders Will Deliver in the Boardroom, “Nurse leaders are uniquely positioned to offer strategic and policy advice to ensure an optimal patient experience.” The institute serves nonprofit hospital and health system boards of directors, executives and physician leadership.
The article encourages healthcare executives to invite more nurses to serve on boards. Nurses make up the largest number of healthcare professionals, yet they hold only about three percent of board positions. Nurses’ experience with patients and the inner workings of hospitals gives them insight that is valuable during strategy and policy discussions that affect the patient experience.
Furthermore, “Nurses are adept and immersed in working in teams, seeing a path forward amidst complexity, and creating and implementing plans to achieve the best patient outcomes and to improve the patient experience. They are able to consider the implications of decisions on staff, patients and their families, the hospital, and the community.”
What Makes A Good Nurse Leader?
The qualities that identify good nursing leaders include looking out for the organization and for patients, staff and team members. According to Jeanine Frumenti, DNP, MPA, RN, CLNC, and owner of Holistic Leadership Consulting, a healthcare administrative consulting firm, “It’s not about them. And their focus stays on the goal.”
Frumenti goes on to say that nursing leaders are “knowledgeable, well-versed in the field and what’s going on in the industry, and are not afraid to make evidence-based decisions.” Plus, they give “those around them a voice, encouraging them to share in the decision-making, and owning their work and their practice.”
Some leadership roles will require more than a BSN. Completing an RN to MSN program or other graduate degree can prepare nurses for executive and educational roles and for advanced practice in a nursing specialty. According to the IOM’s report, “Nurses with graduate degrees will be able to replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions; and provide the leadership needed to establish nurses as full partners in health care redesign efforts.”
Learn about the Lamar University online RN to BSN program.
