Elevating Nursing Leadership at the Bedside

Marcella Honour, RN, MN

Disclosures

NAINR. 2013;13(3):127-130. 

In This Article

Abstract and Introduction

Abstract

If we are to achieve healthy work environments that produce competent nurse leaders at the unit level, care must be taken now to ensure a talent pool of nurse leaders for the future. When nurses at the bedside share in the decision-making authority in their work environments, front-line leadership emerges. Growing talent from within at organizational, microsystem, and corporate strategy levels is important for succession. By investing in our front-line nurses, we can enhance leadership at all levels within the healthcare system and enable nurses to be well-positioned in effecting transformational change.

Introduction

"The nursing profession must produce leaders throughout the health care system, from the bedside to the boardroom, who can serve as full partners with other health professionals and be accountable for their own contributions to delivering high-quality care while working collaboratively with leaders from other health professions" — Institute of Medicine, 2010.[1]

The above quote from the landmark IOM report The Future of Nursing: Leading Change, Advancing Health is a call to action for the profession of nursing.[1] The complexities of today's ever-changing healthcare arena demand that traditional ways of improving clinical outcomes, providing high-quality, safe patient care and balancing fiscal accountabilities are challenged and that a transformation takes place within our healthcare system. Within this multi-layered system, where do front-line Neonatal Intensive Care Unit (NICU) nurses fit in as the future leaders of the profession? In order to sustain nursing excellence within our healthcare system, we must think differently about how we develop nurses so that a steady supply of competent, credible and visionary nurses is well positioned to lead our profession into the future.

But what does it mean to be a leader? Leadership can be defined as the ability to define a vision and guide individuals and groups toward that vision while maintaining group-promoting teamwork, commitment, and effectiveness.[2] In the nursing literature there is a plethora of research and commentary about nursing leadership within a formal context.[3,4,5,6] Fairly recently however, the acknowledgement and promotion of the bedside nurse as a critical leader within healthcare teams are starting to emerge.[7,8,9]

How do we engage all Neonatal Intensive Care Unit (NICU) nurses to become leaders? Benner's 1984 hallmark work, From Novice to Expert, provides a framework, however; leaders in formal roles within our healthcare organizations have an accountability to elevate the leadership capabilities of front-line nurses in order to sustain our health system for the future.[10] In this paper several avenues at the organization, micro-system, and corporate levels for achieving such outcomes in the NICU will be explored. These include education, mentorship, expanded roles, practicing to full scope, and strategic leadership planning for the future. By investing in our front-line nurses, we can enhance leadership at all levels within the healthcare system and enable nurses to be well-positioned in effecting transformational change.[10]

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