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What Nursing Leaders Need To Know: 7 Truths

What’s keeping nursing leaders up at night? Are they still troubled by the old, familiar issues such as patient safety and physician relations?

Or are new concerns elbowing into the mix? Interviews I conducted with top nurse leaders—from CEOs to CNOs to nurse educators—provide insight into today’s special challenges.

All agreed that, as statistics show, elective procedures are down and uninsured emergency visits are up, thanks to the difficulties of the current economic climate. But some of the pros I talked with went beyond the stats and looked deeper into the current state of nursing and important trending issues. What follow are seven truths that nursing professionals know about leading successfully in these unusually challenging times.

1. A nursing shortage really does still exist. In this uncertain economy, with more seasoned nurses returning to work, others going from part time to full time and still others postponing retirement, it’s easy to have a false sense of security about the nursing shortage. Connie Smith, CEO of The Medical Center in Bowling Green, Kentucky, says: “This bubble of filled nursing positions will burst when the economic outlook improves. The need for nurses will continue to increase based on the aging baby boomer population. It has been the position of this organization to overhire when we have qualified candidates. This has been a very successful strategy.”

2. We need a stronger model for developing and grooming nurse leaders. “Education, mentoring programs, better incentives, modeling and replacing ourselves really is the responsibility of leadership,” asserts Anne Evans, CNO of Lutheran Hospital in Wheat Ridge, Colorado. In keeping with her belief, Lutheran Hospital has instituted formal succession planning with the help of the Colorado Center for Nursing Excellence.

3. It is about the money. While we all know patient care comes first, constant conflicting priorities affect decisions about saving resources for front-line services versus investing in management. The current cost of health care is 18 percent of GNP, and something has to be done about it. While health care reform remains a hotly contested issue, we can all agree that the current system just isn’t working. With reimbursement down and uninsured patient populations up, the existing health care system continues to have a dire effect on the bottom line in all facilities.

4. The biggest value in being designated a Magnet hospital is creating a Magnet culture. Donna Paduska is vice president of patient care services at Poudre Valley Hospital in Fort Collins, Colorado, which is ranked No. 18 in the nation and first in Colorado for the highly esteemed Magnet designation. Paduska says, “The desired culture and climate for nursing necessitates that nurses at all levels be highly visible, feel valued for their opinions and experience, and be highly involved in decisions at all levels of patient care.” To feel respected and be the strong team players we expect them to be, nurses need support, as individuals and as part of a working culture in which the entire staff is affirmed. Current conditions have created a critical time for nurse leaders to not only know what they know, but to know what they don’t know.

5. Nursing needs a voice. The staff nurse needs to share his or her vision with leadership and gain a voice at the local, state and national level. Shared governance, nursing practice councils and involvement at upper levels in appropriate decision-making all work to create that kind of high-level presence. “The whole idea of vertical communication is critical, and it starts with the staff nurse and goes all the way up to the board member,” says Emily Weigel, nursing education coordinator at Boulder Community Hospital in Boulder, Colorado. To address vertical communication, Boulder Community created an innovative program that involves every employee in the hospital. Called “Getting the Board on Board,” it assigns board members to patient rounds and selects nurses to attend board meetings.

6. Quality of care is based on confidence and competence. George Rudloff, vice president and CNO of St. Joseph Hospital in Denver, Colorado, says, “Quality is a byproduct of confident and competent practitioners.” To develop nurse confidence and competence at the bedside, St. Joseph Hospital spends a lot of resources on education and quality-advancement measures and is working to incorporate the role of the clinical nurse specialist.

7. Nurse leaders need support now more than ever. With day-to-day management of developmental change, fiscal priorities, reimbursement, budget constraints and the necessity to have a bigger vision, leaders today need support. Investing in outside resources can seem impractical when organizations are cutting back, tightening up and slimming down because of the uncertainty that surrounds health care. The best leaders agree, however, that the numerous and rapid changes that are taking place actually provide reason for every organization to be its best and brightest, with effective meetings, high-functioning committees and strong leadership teams. And, outside consultants can often offer unique and fresh perspectives that help organizations not just keep going, but keep going forward.

What nursing leaders know today is that, as rapid changes take place, contemporary health care presents an array of challenges, some familiar and some new.

The best in the profession are bringing about a needed shift in nursing leadership, which is apparent in their forward-looking visions and actions. Current conditions have created a critical time for nurse leaders to not only know what they know, but to know what they don’t know. By taking the plunge and investing time and energy in professional organizations, outside experts, coaches and consultants, they bring strong, creative health care solutions to fruition and get a better night’s sleep in the process. RNL

Written by Diane Sieg, RN, BSN, CYT, CSP, is a speaker, facilitator, author, life coach and yoga teacher. This email address is being protected from spambots. You need JavaScript enabled to view it.