The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership


  • 1 Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada. Electronic address: [email protected].
  • 2 Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Monash University, Level 1, 264 Ferntree Gully Rd, Notting Hill, VIC 3168, Australia.
  • 3 Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada.
  • 4 Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; Technical High School of Campinas, State University of Campinas (UNICAMP), Barão Geraldo, Campinas - São Paulo 13083-970, Brazil.
  • PMID: 33383271
  • DOI: 10.1016/j.ijnurstu.2020.103842

Background: Nursing leadership plays a vital role in shaping outcomes for healthcare organizations, personnel and patients. With much of the leadership workforce set to retire in the near future, identifying factors that positively contribute to the development of leadership in nurses is of utmost importance.

Objectives: To identify determining factors of nursing leadership, and the effectiveness of interventions to enhance leadership in nurses.

Design: We conducted a systematic review, including a total of nine electronic databases.

Data sources: Databases included: Medline, Academic Search Premier, Embase, PsychInfo, Sociological Abstracts, ABI, CINAHL, ERIC, and Cochrane.

Review methods: Studies were included if they quantitatively examined factors contributing to nursing leadership or educational interventions implemented with the intention of developing leadership practices in nurses. Two research team members independently reviewed each article to determine inclusion. All included studies underwent quality assessment, data extraction and content analysis.

Results: 49,502 titles/abstracts were screened resulting in 100 included manuscripts reporting on 93 studies (n=44 correlational studies and n=49 intervention studies). One hundred and five factors examined in correlational studies were categorized into 5 groups experience and education, individuals' traits and characteristics, relationship with work, role in the practice setting, and organizational context. Correlational studies revealed mixed results with some studies finding positive correlations and other non-significant relationships with leadership. Participation in leadership interventions had a positive impact on the development of a variety of leadership styles in 44 of 49 intervention studies, with relational leadership styles being the most common target of interventions.

Conclusions: The findings of this review make it clear that targeted educational interventions are an effective method of leadership development in nurses. However, due to equivocal results reported in many included studies and heterogeneity of leadership measurement tools, few conclusions can be drawn regarding which specific nurse characteristics and organizational factors most effectively contribute to the development of nursing leadership. Contextual and confounding factors that may mediate the relationships between nursing characteristics, development of leadership and enhancement of leadership development programs also require further examination. Targeted development of nursing leadership will help ensure that nurses of the future are well equipped to tackle the challenges of a burdened health-care system.

Keywords: Interventions; Leadership; Nursing workforce; Systematic Review.

Copyright © 2020. Published by Elsevier Ltd.

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Evidence and practice    

Developing effective nurse leadership skills, denise major deputy director of nursing, salisbury nhs foundation trust, salisbury, wiltshire, england.

• To enable you to outline the various types and characteristics of leadership

• To understand the importance of effective nurse leadership and its effect on patient care

• To identify ways to enhance your leadership skills and apply these in your everyday practice

Leadership is a role that nurses are expected to fulfil, regardless of their job title and experience. Nurses are required to lead and manage care as soon as they have completed their training. However, the development of leadership skills and the associated learning can be challenging, especially for less experienced nurses and those at the beginning of their careers. This article examines the importance of effective leadership for nurses, patients and healthcare organisations, and outlines some of the theories of leadership such as transformational leadership. It also details how nurses can develop their leadership skills, for example through self-awareness, critical reflection and role modelling.

Nursing Standard . doi: 10.7748/ns.2019.e11247

Major D (2019) Developing effective nurse leadership skills. Nursing Standard. doi: 10.7748/ns.2019.e11247

This article has been subject to external double-blind peer review and checked for plagiarism using automated software


[email protected]

None declared

Published online: 07 May 2019

clinical leadership - leadership development - leadership frameworks - leadership models - leadership skills - transformational leadership

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Models of leadership and their implications for nursing practice

S'thembile Thusini

MSc Student, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London

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Julia Mingay

Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London

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Leadership in today's NHS, either as a leader or follower, is everybody's business. In this article, an MSc student undertaking the Developing Professional Leadership module at King's College London describes two leadership models and considers their application to two dimensions of the NHS Healthcare Leadership Model: ‘Engaging the team’ and ‘Leading with care’. The author demonstrates the value of this knowledge to all those involved in health care with a case scenario from clinical practice and key lessons to help frontline staff in their everyday work.

The Ely inquiry into the systematic brutal treatment of patients in a Cardiff mental institution was the first formal inquiry into NHS failings ( Department of Health and Social Security, 1969 ). Since that time there have been more than 100 inquiries with inadequate leadership persistently identified as a major concern ( Sheard, 2015 ). National responses have included the NHS Healthcare Leadership Model, delivered by the NHS Leadership Academy and its partners (2013) . A range of online and face-to-face programmes aim to increase an organisation's leadership capacity by developing leaders who pay close attention to their frontline staff, understand the contexts in which they work and the situations they face and empower them to lead continuous improvements that enhance patient outcomes and safety ( NHS Leadership Academy, 2013 ).

At King's College London, ‘Developing Professional Leadership’ is a core module of the Advanced Practice (Leadership) pathway. The module critically appraises theoretical and professional perspectives on leadership and supports participants to take up leadership roles with attention to ethical practice. Both national and college leadership activities promote an understanding of vertical transformational leadership (VTL) and shared leadership (SL).

Vertical transformational leadership

VTL is a hierarchical leadership model that describes an individual leader who, through various influences and mechanisms, elevates himself or herself and followers towards self-actualisation ( Pearce and Sims, 2000 ). VTL values collaboration and consensus, integrity and justice, empowerment and optimism, accountability and equality, and honesty and trust ( Braun et al, 2013 ). A vertical transformational leader inspires others by interpreting complex data, creating a vision and formulating a strategy for its attainment ( Avery, 2004 ). They aim to create an organisation that is agile, responsive, open to learning and future ready through innovation and creativity. They do this by appealing to followers' emotions and internal motivations, and by building rewarding relationships and raising morale. They use delegation, consultation and collaboration to engage followers but retain power so that responsibility and accountability for a vision and its strategy rests with the leader ( Avery, 2004 ).

Behaviours associated with this leadership style have been classified by Avolio et al (1991) as the four ‘I's: idealised influence, individualised consideration, inspirational motivation, and intellectual stimulation:

  • ‘Idealised influence’ represents the charismatic part of VTL. Leaders model integrity, optimism and confidence, and act with courage and conviction demonstrating their intellectual and technical skills
  • ‘Individualised consideration’ requires self-awareness and an appreciation of the values, aspirations, motivations, strengths and weaknesses of others. From this perspective leaders need to be able to listen and communicate effectively, and may be called upon to teach, coach, mentor or counsel
  • ‘Inspirational motivation’ necessitates a clearly communicated vision and belief in a team's abilities to achieve a desired goal
  • Through ‘intellectual stimulation’ leaders support and facilitate independent thinking, encouraging followers to be more rational, creative and innovative in their decision-making and problem-solving.

Tse and Chiu (2014) have advised that leaders adopt a balanced approach to the use of the four Is that is contingent upon their followers' orientation. For example, if group cohesion is required then idealised influence and inspirational motivation are appropriate leader behaviours. However, if greater creativity is needed from staff, then a leader is advised to exhibit individual consideration and provide intellectual stimulation. Conversely, mismatching leadership behaviour to follower orientation can have detrimental effects. For example, providing intellectual stimulation with high expectations but offering insufficient individualised consideration.

During times of large-scale dramatic organisational change an effective vertical leader is necessary for recalibrating and reviving an organisation ( Binci et al, 2016 ). They can provide clarity, motivation and empowerment. There are several examples of positive VTL outcomes in NHS trusts that have managed to improve their Care Quality Commission ratings. This was achieved through measures to revive cultures and empower staff with open communications and active support ( Health Foundation, 2015 ). Critics argue that VTL dependence on a single figure can be futile for an organisation, especially if the individual is prone to dysfunctional behaviour ( Wang and Howell, 2012 ). In response, an ‘authentic leader’ is proposed ( Jackson and Parry, 2011 ); this is someone with a ‘high socialised power orientation’, who is humble, modest, deflects recognition for achievements, who celebrates the team, and exhibits vertical and shared leadership behaviours. Through self-awareness and reflecting on actions a VTL leader can exhibit authentic leadership behaviour.

VTL overlaps other leadership approaches including authentic, servant, charismatic, inspirational and visionary ( Avery, 2004 ). What often differentiates VTL is its motivation or focus, which is typically on achieving organisational goals. VTL is also associated with pseudo-transformational and transactional leadership. The former is a dysfunctional form of charismatic leadership, characterised by narcissistic behaviours associated with dictators and sensational political and corporate leaders. Transactional leadership is practised by positional managers whose job it is to set expectations and engage in corrective or autocratic measures that aim to maintain efficiency. Transformational leaders do utilise some transactional methods to achieve goals and the two leadership styles can be complementary. However, VTL is two-way leadership with follower influence whereas transactional leadership represents one-directional hierarchical leadership.

Shared leadership

SL is a non-hierarchical leadership model that describes leadership that emerges within a group, depending on the context and skills required at a given time ( D'Innocenzo et al, 2016 ). SL values openness and trust, engagement and inclusiveness, reciprocity and fluidity, democracy and empowerment, and networking and support ( Jameson, 2007 ). Shared leaders are peers who possess no authority over the group outside the context of their shared contribution. Individual leadership is de-emphasised and a vision and its strategy are created and owned by the group. Open discursive engagement is favoured for mutual sense making through the pooling of diverse skills, knowledge and experience. SL is dynamic, multidirectional and collaborative. Power is shared so that responsibility and accountability for a vision and its strategy rests with the group ( Avery, 2004 ).

SL is often associated with, but different conceptually from, co-leadership, distributed leadership, and self-managing teams. Carson et al (2007) suggested that these all lie on a continuum with co-leadership at one end and shared leadership at the other. Participation, consultation and delegation are used in SL as are the four Is of transformational leadership. SL has been described as a type of group transformational leadership as transformational behaviours within a shared leadership model achieve similar results to VTL ( Wang and Howell, 2012 ). SL necessarily exists in organisations such as the NHS where different professional groups with their own leadership structures need to collaborate. Transforming a culture through shared leadership requires patience and investment. It is an iterative process involving cycles of learning and reflection that require trust, personal and professional maturity, and organisational support.

SL leadership behaviours can become widespread within teams, lessening their dependence on one leader and the potential effects of rogue single leaders ( The King's Fund, 2011 ). This is vital in environments where problems are increasingly complex and leaders are required to possess multiple problem-solving skills. Cost efficiencies can result from diminishing hierarchical leaders' workloads and a consequent reduction in their posts among highly skilled cohesive groups ( Tse and Chiu, 2014 ). Critics argue that SL efficiency is influenced by group dynamics, which may be prone to relationship conflicts that lead to decision paralysis ( Pearce and Sims, 2000 ). Additionally, the emergence of a vertical leader who could manipulate the workforce for political or corporate gain may be an unintended consequence of SL.

Both VTL and SL are moderated by internal and external factors. VTL is influenced by levels of trust, follower receptiveness, personality traits, task complexity and urgency. Stress and burnout can lessen leadership benefits while trust can enhance performance outcomes ( Robert and You, 2018 ). SL is moderated by trust, time, group size and cohesion, skill mix, confidence, task complexity and interdependence ( Nicolaides et al, 2014 ). Trust, sufficient time, a balanced skill mix and group cohesion have a positive influence, while task complexity, especially at formative stages, hinders effective SL.

The two approaches are complementary. During the formative stages of shared leadership, a vertical leader is crucial to guide and sustain shared leadership. Some final decisions will need to rest with the hierarchical leader. As the team gains confidence, a vertical transformational leader's role evolves to consultant, mentor, facilitator and, at times, recipient of group leadership. A significant body of evidence associates VTL and SL with positive individual, group and organisational outcomes ( Wang and Howell, 2012 ; Nicolaides et al, 2014 ; D'Innocenzo et al, 2016 ). VTL predominantly influences individual and organisational outcomes while SL is more influential at the group and organisational levels. Table 1 summarises some of the differences between the approaches, although they share much more in common.

VTL and SL are both appropriate in healthcare contexts and can be complementary under the right circumstances. The key is being able to recognise appropriate opportunities to develop and utilise each as either a leader or follower ( Binci et al, 2016 ). Familiarity with the models, their methods and uses are important in these respects. It is equally important to recognise and engage in any cultural change that may be necessary for leadership to be effective. Transformational change does not have to be revolutionary or top-down. Minor changes at the frontline can deliver significant benefits if team members are engaged and led with care.

  • Whether you are a leader or a follower, leadership is at the heart of NHS activity and all nurses have a responsibility to ensure it is effective
  • Vertical transformational and shared leadership models are promoted by national leadership programmes that support the development of NHS staff
  • The two models are complementary, and it is important to be aware of opportunities to develop and utilise each as either a leader or follower
  • Leading with care can inspire and motivate teams to engage in transformative change
  • Familiarisation with leadership models and their application in practice is important for the development of nurses and the organisations in which they work, and for the assurance of patient safety

CPD reflective questions

  • What can you do to demonstrate leadership within your own capacity in your clinical setting?
  • Considering that ‘followership’ is an integral part of NHS leadership, what can you do to demonstrate responsible followership?
  • Reflect on a time where you demonstrated leadership or observed leadership in your clinical area; what leadership qualities can you recognise from that scenario?

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What is Nurse Leadership?

A nurse leader with a stethoscope, leading a meeting with a group of other nurses

This article was updated on October 12, 2023 with additional contributions by Mars Girolimon.

Leaders are found everywhere, from government leaders to corporate leaders to leaders in local communities. You name the setting; we look toward leaders at the helm.

The nursing profession is no exception. Leaders in nursing are influencing healthcare organizations at all levels, and in every setting and discipline. “While nursing leadership is considered a relatively new role in the healthcare setting, the impact and influence of leadership [in the nursing profession] throughout history has been well-documented," said Mandy T. Bell, DNP, MSN, RN , clinical faculty of graduate nursing programs  at Southern New Hampshire University (SNHU). After all, the concept of leadership is “not confined to individuals who possess traditional positions of authority or scope of responsibility. Rather, anyone within an organization can be a leader,” she said.

So, what makes a nurse a leader and why is that important?

What is a Nurse Leader?

Nursing lends itself to attracting and developing strong natural leaders. There is no universally accepted definition, framework, or theory of nurse leadership. “However, most authorities in the profession agree on common leadership traits and skill sets that make a nurse leader,” Bell said.

As Bell defines it, nursing leadership is "the ability to inspire, influence and motivate nursing staff and other health care workers to work together to achieve their highest potential and collective organizational goals."

Why is Leadership Important in Nursing?

Dr. Mandy Bell with the text Dr. Mandy Bell

All of this change does have a silver lining. “The pandemic served as a catalyst for change and innovation as nurse leaders from all levels of nursing responded to the new challenges presented by COVID-19,” said Bell.

In order to accommodate the increased demands of managing patient care during the pandemic, nurse leaders across all levels of the profession "created new models of care and new workflows using technology such as video conferencing and telemedicine to communicate with patients and with other healthcare workers. They also identified ways to prevent shortages from the overuse of scarce resources such as personal protective equipment (PPE). ” Bell said.

As we move forward in healthcare, the innovations created by nurse leaders, like the role of telehealth in nursing , endure and will continue to help to advance the profession.

What is the Role of a Nurse Leader?

A primary role of the nurse leader is to serve as a role model to healthcare and team members. Being able to effectively communicate the goals and expectations of each team member is key. “Essentially, everyone needs to know their role and the roles of the other team members to be able to work together in attaining common organizational goals,” Bell said.

Leadership in nursing begins at the bedside. Then, “by developing and honing their fundamental leadership skills, bedside nurses can positively impact patient outcomes,” said Bell.

Clinical and bedside nurses use leadership skills to coordinate, direct and support patient care and other healthcare team members. They also possess effective communication skills  and serve as a patient advocate.

What Are Qualities of a Good Leader in Nursing?

To be effective in influencing and engaging others toward operationalizing goals, the emotionally intelligent nurse leaders  must be well-versed in both hard and soft skills.

“The hard skills for nurse leaders include advanced clinical knowledge and technical skills that the nurse leader needs to perform their job. Soft skills are the social skills that need to be consciously developed over time and help the nurse leader effectively communicate with peers and subordinates alike,” Bell said. “In other words, the soft skills are critical  for the nurse leader to get along with others in the workplace.”

Soft skills include:

  • Creating a culture that drives high reliability : over time and across the organization’s performance that positively impacts patient safety and quality outcomes
  • Creativity and innovation : by thinking mindfully and being open to new experiences and technologies to improve the status quo.
  • Dedication to excellence : by applying current and evidence-based practice, demonstrating consistency and passion for the profession, and engaging in lifelong learning
  • Excellent interpersonal skills : by using effective written and verbal communication skills, active listening, clarity, confidence, and empathy.
  • Sense of teamwork and collaboration : clearly defined roles and expectations, working toward common goals, and being accountable. As well as coaching and mentoring a culturally diversified workforce.

Additionally, a successful nurse leader must be knowledgeable about:

  • The health care system, advocacy, and policy
  • Conflict resolution and negotiation
  • Finance, business, and human resource management
  • Strategic management
  • Professional development
  • Self-care , such as practicing mindfulness  and developing resiliency

These combined skills promote increased productivity, higher staff satisfaction, and lower staff turnover. This leads to high quality of care plus excellent safety and desirable patient outcomes.

A blue infographic piece with the text Nurse leadership is "the ability to inspire, influence and motivate nursing staff and other health care workers to work together to achieve their highest potential and collective organizational goals." — Dr. Mandy Bell

What Are Examples of Nurse Leadership?

Being a leader in the field of nursing can come in many forms, but Nurse Journal notes three major types of positions for nurse leaders:

  • Nurse administrators : Nurse administrators oversee nursing staff, perform human resources tasks  and represent their department, area or practice to external stakeholders, according to Nurse Journal.
  • Nurse managers : Nurse Journal said nurse managers "are leaders in their units and oversee patient care and daily operations, making sure that the workflow and procedures align with the facility's overall strategic plan and goals."
  • Nurse executives : The most senior nurses may become nurse executives, administrators with additional financial responsibilities who collaborate with partners both inside and outside their organization, Nurse Journal reports.

According to the U.S. Bureau of Labor Statistics ( BLS ), medical and health service managers made a median of $104,830 in 2022, and BLS projects a 28% growth rate by 2032 — much faster than average.*

How Does One Become a Nurse Leader?

While leading comes naturally for many people, nurses, by definition of their challenging and multi-faceted roles, develop more leadership skills while on the job. All nurses within the healthcare organization can assume a role as a leader through embracing the various leadership styles in nursing . They do not need to be in a defined role of authority to exhibit these skills and traits. Leadership in nursing can be accomplished “through experience, pursuing certification and an advanced degree,” said Bell.

Before you earn an advanced degree, you'll need to complete your undergraduate education. According to BLS, medical and health service manager roles typically require a bachelor's degree and up to five years of experience in the field. A Bachelor of Science in Nursing (BSN) is  the preferred choice for many nursing professionals.

Find Your Program

When Danielle Jernigan '23 decided to earn her BS in Nursing  from SNHU, she was working as a nurse in New York City. "Initially, I wanted to get my BSN so that I could apply for better jobs. As a nurse, most employers prefer to hire BSNs, especially the city hospitals," Jernigan said.

Once she started her program, Jernigan became more motivated to seek leadership and management positions in nursing. "With this degree, I am able to advance in my career, and I have already applied for a supervisory role within my current department," she said. "I am more confident in my abilities because the knowledge is there to back it up."

Jernigan said she's eager to learn more and is currently in the process of applying for an MSN Nurse Practitioner  program.

Some universities, like SNHU, also offer MSN Nurse Leadership programs that can help you earn the credentials and preparation you need to advance to the next level.

Above all, a nurse leader must “be agile and flexible in adapting to a rapidly changing environment,” Bell said. Nurse leaders must be prepared to respond swiftly to:

  • Changes in regulatory and legislative requirements
  • New treatment modalities
  • New and ever-changing technologies, including computer use, artificial intelligence (AI), telemedicine, and electronic patient care documentation
  • Evidence-based practices, which includes staying current on the latest best practices, conducting research, and sharing research findings

Keep in mind that the necessary skills to be a nurse leader will change as the profession changes. With each new demand on the world of health care, the need for nurses to be agile grows.

Why is Nurse Leadership Development Important?

Nurses are the cornerstone for any healthcare organization. Effective nurse leadership “is critical for strengthening integration of safe, effective and high-quality care,” Bell said. “This, in turn, creates a positive work environment and promotes positive patient outcomes and experiences,” for patients and staff alike.

The ability to transform business practices as well as patient care is profound. Strong leaders manage staff effectively. Confident and capable staff members who trust in their ability to lead result in “increased staff productivity, morale and job satisfaction,” Bell said. That’s good for everyone.

What’s the Bottom Line?

It’s no secret that nursing is a challenging profession. On a good day, nurses can work up to 12 hours in a shift, on their feet, managing multiple patients with competing needs and demands. Nurses work nights, weekends and holidays. They must have laser-sharp attention to detail, be business-minded and show an exceptional amount of compassion and empathy to those around them.

To be effective, “a key responsibility for a nurse leader is to engage in self-awareness,” said Bell. Nurses who continuously develop their own advanced skill set are investing in themselves and their career. “It is important for the nurse leader to continuously reflect on their leadership strengths and identify opportunities for continued professional growth.” This will help nurse leaders continue to proactively drive positive change in healthcare.

As we move into the future, advances in technology, treatment regimens and the rapidly changing healthcare landscape, and global demographics, there will be even more demands for nurses at all levels to assume a leadership role. Nurses and other healthcare professionals will also continue to look within the nursing profession for leadership. According to Bell: “It will be more important than ever for nurses to assume leadership roles to proactively respond and adapt to each new challenge and continue to advance the profession.”

Discover more about SNHU’s online MSN program : Find out what courses you'll take, skills you’ll learn and how to request information about the program.

*Cited job growth projections may not reflect local and/or short-term economic or job conditions and do not guarantee actual job growth. Actual salaries and/or earning potential may be the result of a combination of factors including, but not limited to: years of experience, industry of employment, geographic location, and worker skill.

Marie Morganelli, PhD, is an educator, writer and editor.

Mars Girolimon '21 '23G is a staff writer at Southern New Hampshire University where they earned their bachelor's and master's, both in English and creative writing. In addition to their work in higher education, Girolimon's short fiction is published in the North American Review, So It Goes by The Kurt Vonnegut Museum & Library, X-R-A-Y and more. They're currently writing their debut novel, which was Longlisted for The First Pages Prize. Connect with them on LinkedIn and X, formerly known as Twitter .

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Inspiring Leadership in Nursing: Key Topics to Empower the Next Generation of Nurse Leaders

Nursing leadership plays a crucial role in the healthcare industry, influencing the quality of patient care and the overall performance of healthcare organizations. As the nursing profession continues to evolve, aspiring nurse leaders must stay informed about the latest developments and best practices in nursing leadership. This comprehensive guide explores essential nursing leadership topics, offering valuable insights and strategies for success.

The Importance of Nursing Leadership

Impact on patient care.

Effective nursing leadership directly impacts patient care, ensuring that nurses provide safe, high-quality, and evidence-based care. Nurse leaders play a critical role in developing and implementing policies, protocols, and standards of practice that promote positive patient outcomes.

Topic Examples

  • The role of nurse leaders in reducing hospital-acquired infections
  • How nurse leaders can improve patient satisfaction
  • The effect of nursing leadership on patient safety initiatives
  • Combating health care-associated infections: a community-based approach
  • Nurse leaders’ impact on the reduction of medication errors
  • Promoting patient-centered care through nursing leadership
  • The role of nurse leaders in implementing evidence-based practices to improve patient outcomes
  • How transformational leadership can positively impact patient satisfaction
  • The impact of nurse leaders on patient safety and error reduction initiatives

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Influence on Organizational Performance

Nurse leaders contribute to the overall performance of healthcare organizations by guiding and supporting nursing teams, managing resources, and participating in decision-making processes. Their leadership helps create a positive work environment, reduce staff turnover, and improve patient satisfaction.

  • How nurse leaders can contribute to reducing staff turnover
  • The role of nurse leaders in improving the hospital’s financial performance
  • Nurse leaders as drivers of organizational culture
  • The integral role of nurses in healthcare systems: the importance of education and experience
  • The relationship between nurse leadership and hospital readmission rates
  • How nurse leaders can contribute to reducing healthcare costs
  • The role of nurse leaders in promoting interprofessional collaboration to improve organizational performance
  • Strategies for nurse leaders to foster a positive work environment
  • The impact of nursing leadership on employee engagement and satisfaction

Advancement of the Nursing Profession

Nurse leaders advocate for nursing, promoting professional development, innovation, and research. They also work to elevate the nursing profession’s status, fostering collaboration and interdisciplinary partnerships.

  • The role of nurse leaders in shaping the future of nursing education
  • How nurse leaders can advocate for the nursing profession
  • The impact of nurse leaders on the development of nursing standards and policies
  • Encouraging research and evidence-based practice among nursing teams
  • The role of nurse leaders in promoting interprofessional collaboration
  • Encouraging the pursuit of advanced nursing degrees and certifications among nursing staff
  • The impact of nurse leaders on shaping healthcare policies and regulations
  • How nurse leaders can advocate for improved working conditions and fair compensation for nursing staff

Essential Nursing Leadership Skills

Communication and interpersonal skills.

Effective communication and interpersonal skills are crucial for nursing leaders. They must listen actively, express themselves clearly, and demonstrate empathy and understanding when interacting with colleagues, patients, and families.

  • Active listening skills for nurse leaders
  • Developing emotional intelligence in nursing leadership
  • The role of nonverbal communication in nursing leadership
  • Strategies for nurse leaders to improve communication with their teams
  • How nurse leaders can facilitate open and honest feedback
  • The importance of emotional intelligence in nurse leadership
  • Strategies for nurse leaders to improve their communication skills with diverse populations
  • The role of nurse leaders in fostering effective communication within interdisciplinary healthcare teams

Decision-Making and Problem-Solving Abilities

Nurse leaders must be skilled in making informed decisions and solving complex problems. They should be able to analyze situations, weigh the pros and cons of various options, and choose the best course of action.

  • Critical thinking skills for nurse leaders
  • Ethical decision-making in nursing leadership
  • The role of evidence-based practice in nursing leadership decisions
  • Strategies for nurse leaders to develop effective problem-solving skills
  • The importance of collaboration and teamwork in decision-making for nurse leaders
  • The role of nurse leaders in crisis management and emergency preparedness
  • How nurse leaders can develop effective problem-solving strategies to address complex healthcare challenges

Time Management and Organization

Managing time and resources effectively is essential for nurse leaders. They must be able to prioritize tasks, delegate responsibilities, and balance competing demands to ensure the smooth operation of their teams and organizations.

  • Prioritization techniques for nurse leaders
  • The role of delegation in effective time management for nursing managers
  • Strategies for nurse leaders to manage workload and reduce stress
  • Balancing clinical and administrative responsibilities as a nurse leader
  • Time management tools and techniques for nurse leaders
  • The importance of delegation in nurse leadership
  • Strategies for nurse leaders to effectively manage their workload and prioritize tasks
  • The role of nurse leaders in creating efficient workflows and processes within nursing teams

Embracing Diversity and Inclusivity in Nursing Leadership

The value of a diverse nursing workforce.

A diverse nursing workforce brings unique perspectives, experiences, and skills to the healthcare environment, benefiting patient care. By embracing diversity, nurse leaders can foster a more inclusive and supportive work environment that encourages collaboration and innovation.

  • The benefits of diverse nursing teams for patient care
  • The role of nurse leaders in recruiting and retaining diverse nursing staff
  • Addressing health disparities through a diverse nursing workforce
  • The impact of cultural competence on nursing practice and leadership
  • Encouraging diverse perspectives and experiences in nursing teams
  • Global health learning in nursing and health care disparities
  • The benefits of having a diverse nursing workforce on patient outcomes and satisfaction
  • Addressing health disparities through culturally competent nursing leadership

Strategies for Promoting Diversity and Inclusion

Nurse leaders can promote diversity and inclusion by implementing hiring and promotion practices that support equal opportunities, offering cultural competency training, and actively addressing discrimination and bias within their organizations.

  • Overcoming unconscious bias in nursing leadership
  • The role of nurse leaders in fostering an inclusive work environment
  • Strategies for promoting diversity and inclusion in nursing education
  • The impact of diversity and inclusion on nursing team performance
  • Encouraging cultural competence and sensitivity among nursing staff
  • Implementing diversity and inclusion training programs for nursing staff
  • The role of nurse leaders in fostering a culture of respect and inclusivity within nursing teams
  • Strategies for nurse leaders to address unconscious bias and promote equity in the workplace

Developing and Mentoring Future Nurse Leaders

Identifying and nurturing leadership potential.

Nurse leaders play an essential role in identifying and nurturing the leadership potential of their staff. By offering guidance, encouragement, and opportunities for growth, they can help prepare the next generation of nurse leaders.

  • Recognizing leadership potential in nursing staff
  • Strategies for nurse leaders to develop their team’s leadership skills
  • The importance of succession planning in nursing leadership
  • Encouraging a growth mindset among nursing teams
  • The role of mentorship and coaching in nurturing future nurse leaders
  • Strategies for nurse leaders to identify and develop emerging nurse leaders within their teams
  • The role of nurse leaders in creating leadership development programs for nursing staff

Mentorship and Coaching

Mentorship and coaching are invaluable for aspiring nurse leaders. By sharing their knowledge, experience, and insights, experienced nurse leaders can help guide and support those looking to advance in nursing.

  • The benefits of mentorship for both mentors and mentees in nursing
  • Developing effective mentoring relationships in nursing
  • The role of nurse leaders in fostering a mentoring culture
  • Strategies for providing constructive feedback and coaching to nursing staff
  • Encouraging professional growth and development through mentorship
  • The benefits of mentorship relationships for both mentors and mentees in nursing
  • Strategies for nurse leaders to establish effective mentorship programs within their organizations
  • The role of nurse leaders in providing coaching and feedback to nursing staff for professional growth

Promoting Teamwork and Collaboration in Nursing

The importance of teamwork in healthcare.

Teamwork is crucial for delivering safe, high-quality patient care. Nurse leaders must foster a culture of collaboration, encouraging open communication, mutual support, and shared decision-making among their teams.

  • The role of nurse leaders in promoting effective teamwork
  • Strategies for building trust and collaboration among nursing teams
  • The impact of teamwork on patient care and safety
  • The benefits of interprofessional collaboration in healthcare
  • The role of nurse leaders in fostering a positive team culture
  • The role of nurse leaders in promoting collaboration and teamwork among nursing staff
  • Strategies for nurse leaders to address and resolve conflicts within nursing teams
  • The impact of effective teamwork on patient outcomes and staff satisfaction in healthcare settings

Strategies for Building Effective Nursing Teams

Nurse leaders can build effective nursing teams by promoting shared goals and values, providing clear expectations and feedback, and recognizing and celebrating team achievements. Additionally, they should facilitate team-building activities and opportunities for professional development, which can strengthen team cohesion and performance.

  • The importance of clear communication and expectations in nursing teams
  • Strategies for addressing and resolving conflicts within nursing teams
  • The role of team-building activities in fostering collaboration and trust among nursing staff
  • The impact of shared decision-making on nursing team performance
  • Encouraging a culture of continuous improvement and learning within nursing teams
  • The role of nurse leaders in selecting and retaining top nursing talent
  • Strategies for nurse leaders to create a positive work environment that fosters teamwork and collaboration
  • The importance of team-building activities and exercises for nursing staff

Advocating for Nursing and Improving Patient Care

Policy and advocacy.

Nurse leaders are responsible for advocating for policies and initiatives that support the nursing profession and improve patient care. They should be informed about healthcare legislation, engage in advocacy efforts, and encourage their teams to participate in policy-making.

  • The role of nurse leaders in shaping healthcare policy
  • Strategies for nurse leaders to advocate for the nursing profession at the local, state, and national levels
  • The impact of nursing leadership on the development and implementation of healthcare policies and regulations
  • Engaging nursing staff in policy discussions and advocacy efforts
  • The importance of staying informed about current healthcare policy issues for nurse leaders
  • The role of nurse leaders in advocating for policies that improve patient care and support the nursing profession
  • Strategies for nurse leaders to effectively engage with policymakers and stakeholders
  • The impact of nurse leaders on shaping healthcare policies at the local, state, and national levels

Driving Quality Improvement and Innovation

Nurse leaders must be committed to continuous quality improvement and innovation in patient care. By staying informed about evidence-based practices and encouraging their teams to adopt innovative approaches, they can drive positive change within their organizations and the healthcare industry.

  • The role of nurse leaders in promoting a culture of continuous quality improvement
  • Strategies for nurse leaders to identify and address areas for improvement in patient care
  • The impact of nursing leadership on the implementation of evidence-based practices and innovations
  • Encouraging a culture of creativity and innovation among nursing teams
  • The role of nurse leaders in driving change and improvement in healthcare organizations
  • The role of nurse leaders in leading quality improvement initiatives within their organizations
  • Strategies for nurse leaders to foster a culture of continuous improvement and innovation among nursing staff
  • The impact of nurse-led quality improvement projects on patient care and organizational performance

Fostering a Positive Work Environment

Creating a supportive and respectful culture.

A positive work environment is essential for nursing staff satisfaction, retention, and performance. Nurse leaders should foster a culture of support and respect where staff feels valued, empowered, and motivated to provide the best possible care.

  • The role of nurse leaders in fostering a positive work environment
  • Strategies for nurse leaders to promote a culture of support and respect among nursing staff
  • The importance of addressing and preventing workplace bullying and incivility in nursing
  • Encouraging open and honest communication within nursing teams
  • The role of nurse leaders in promoting work-life balance and well-being among nursing staff

Addressing Workplace Challenges and Conflicts

Nurse leaders must be proactive in addressing workplace challenges and conflicts. They can maintain a healthy and productive work environment by developing and implementing strategies to manage issues such as workload, burnout, and interpersonal conflicts.

  • The role of nurse leaders in conflict resolution within nursing teams
  • Strategies for nurse leaders to address common workplace challenges, such as staffing shortages and burnout
  • The importance of developing a proactive approach to addressing conflicts and challenges in nursing
  • Promoting a culture of accountability and responsibility among nursing staff
  • The role of nurse leaders in providing support and resources for nursing staff facing challenges and conflicts
  • Conflict resolution strategies for nurse leaders
  • The role of nurse leaders in mediating and resolving interprofessional conflicts within healthcare teams
  • Strategies for nurse leaders to prevent and address workplace burnout among nursing staff

Lifelong Learning and Professional Development

Commitment to continuing education.

Lifelong learning is essential for nurse leaders to stay current with healthcare and nursing practice advances. They should pursue continuing education opportunities, research, and stay informed about industry trends and best practices.

  • The importance of lifelong learning for nurse leaders and nursing staff
  • Strategies for nurse leaders to promote a culture of continuous education and professional development within their teams
  • The impact of continuing education on nursing practice and leadership
  • Encouraging nursing staff to engage in professional development opportunities
  • Transforming advanced nursing practice: embracing IOM recommendations and higher education
  • The role of nurse leaders in staying informed about current nursing research and best practices
  • The impact of continuing education on nursing practice and patient outcomes
  • Strategies for nurse leaders to support and encourage continuing education among their nursing staff
  • The role of nurse leaders in staying up-to-date with the latest nursing research, guidelines, and best practices

Encouraging Professional Development in Nursing Teams

Nurse leaders should support and encourage the professional development of their nursing teams. By providing resources, opportunities, and encouragement, they can help their staff grow professionally and contribute to advancing the nursing profession.

  • The role of nurse leaders in identifying professional development opportunities for nursing staff
  • Strategies for nurse leaders to create individualized professional development plans for their team members
  • The importance of fostering a growth mindset among nursing staff
  • Encouraging nursing staff to participate in conferences, workshops, and other professional development activities
  • The role of nurse leaders in providing mentorship and guidance for nursing staff seeking career advancement
  • The benefits of ongoing professional development for nursing staff and healthcare organizations
  • Strategies for nurse leaders to create professional development opportunities within their organizations
  • The role of nurse leaders in developing and implementing career advancement pathways for nursing staff

The Power of Inspiring Leadership in Nursing

Nursing leadership is a critical component of the healthcare industry, impacting patient care, organizational performance, and the advancement of the nursing profession. By mastering essential leadership skills, embracing diversity, promoting teamwork, and fostering a positive work environment, aspiring nurse leaders can make a meaningful difference in the lives of their patients, colleagues, and organizations. Committing to lifelong learning and professional development will ensure that nurse leaders remain at the forefront of their field, inspiring and empowering the next generation of nursing professionals.

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Nursing Leadership and Personal Skills Personal Essay


Strong leadership is required to establish a healthy working environment at all levels of an organization. Evidence shows that the presence of a nurse leader in an emergency department of a health facility makes the working environment healthy while at the same time increasing staff retention. In line with this, the American Association of Critical Care Nurses has revealed that for optimal performance of staff and improved patient care, nurse leadership needs to be developed. I have realized the importance of nurse leadership. For this reason, I intend to share my experience at my workplace and relate it with various theories, leadership styles, and technology.

Experience with the Supervisor

As quoted by Lachlan Mclean, “You can only lead others when you are willing to go.” My Emergency Room Director at Providence Park in the Emergency Department (ED) is an example of this. She allows us to help and motivate each other to become better through teamwork. She creates a positive working environment where all nurses can improve themselves through creativity and sharing of information. At one time, she asked for my opinion on the ED and on how she could make it better. It was an excellent opportunity to be creative and contribute to the improvement of this department.

Emergency Nurses Association (ENA)

The Emergency Nurses Association was formed to serve emergency nurses in different ways. The main purpose of ENA is to enhance service delivery through continuous training, research, and funding of other projects. The services offered by ENA ensure continuous improvement of service delivery. It also assists in finding solutions to new problems in the field of nursing (Hammond & Zimmermann, 2012). In addition, ENA provides an opportunity for one to contest for a position in management. One crucial role of ENA in the emergency room (ER) is leadership training. Leadership training is essential in the emergency room as it contributes to coordination and teamwork. ENA has gone further to partner with ENA Foundation in order to improve service delivery.

Time Management

According to Magnet’s Model of transformational leadership, time management, and leadership cannot be separated. My area of operation deals with emergencies and patients in critical conditions. As such, time wastage jeopardizes the lives of patients. In sharpening my time management skills, I have resorted to prioritizing and delegating duties. Prioritizing has allowed me to deal with urgent issues while delegation has enabled me to seek the help of my subordinates. Otherwise, as a team leader, possession of such qualities has enabled me to inspire and create a sense of commitment among my team members.

Leadership Skills

The issues of leadership and management have been taken to mean the same thing. However, a manager exerts authority over others. This means that, others are not involved in decision-making unlike in leadership where the views of all stakeholders are taken into consideration. Since leadership calls for the participation of all, it is important that managers possess some leadership skills to enhance teamwork.

Nurse leaders can execute their functions efficiently depending on how powerful they are. There are various sources of power. They include the legislative, professional qualification and personal qualities. The legislative provides rules and regulations meant to guide the activities of nurses. They govern the responsibilities of a nurse and determine the steps to take in various situations (Lauby, 2010). Secondly, possession of professional skills gives nurses the power to act according to their level of qualification. Finally, personal qualities determine the nurses’ ability to lead.

My personal skills have a significant impact on my leadership skills. I am very persistent, determined and communicative. My persistent nature has enabled me to stay focused on achieving my goals. My determination has kept me going even when faced with challenges. Moreover, I am very communicative. This quality has enabled me to develop a good working relationship with my workmates. However, I don’t like being criticized. This quality has affected my performance as a team leader and had severe adverse impacts on the results of the team. For this reason, I am trying very hard to change my behavior for the benefit of my group and patients (Manojlovich, 2007).

Change and Conflict Handling

Nurses, apart from executing their duties, also act as change agents. They initiate changes that impact the nursing field. One way through which they bring change is by contesting various political positions. When they win in such contests, they can push for favorable legislation (Barker & DeNisco, 2013). Another way is by applying various organizational and change theories. Organizational theories are applied in specific contexts to bring orderliness while change theories are mainly applied to bring about behavioral changes which help nurses to co-exist and relate well with patients. This helps to avoid the emergence of conflicts.

Conflicts are bound to arise in any setting and the nursing field is no exception. As such, methods of handling conflicts are necessary. One of the effective ways is through compromise. Another alternative is the avoiding strategy, where the focus is on creating delays in conflicts so that measures to combat them are put in place.

Leadership and Differences in Character

The issues of culture and gender have resulted in a number of differences among people. These differences have had an impact on performance at work. According to Lieberman (2015), men originated from Mars while women came from Venus. This difference according to him has had an impact on the style of communication. A good nurse leader should appreciate such differences and devise a plan to overcome them.

Emotional Intelligence

Nurse leaders should possess Emotional Intelligence (EI) skills. EI enables them to read emotions and make the necessary adjustments according to the perceived emotional state of their subordinates (Cassady & Eissa, 2008). Cassady and Eissa (2008) illustrated this by carrying out an experiment using a nurse who worked in a very busy ED of a hospital. The nurse was subjected to different types and levels of stressful situations. In this case, emotions were frayed and as a result the nurse was unable to function well. EI enables leaders to strike a balance between work performance and emotion, and as such enables the application of measures that ensure emotions do not affect the performance of nurses.

Nursing Informatics

Nursing Informatics is the use of information systems and electronic health records in the provision of health services. It helps nurse leaders to carry out their functions efficiently by making information readily available to them. The same systems assist in administration by helping in relaying information quickly. However, nursing Informatics may detach leaders from their subordinates and for this reason kill the spirit of teamwork (McCartney, 2004).

Nurse leaders perform numerous duties in emergency departments which require them to possess excellent leadership skills that will enable them to work efficiently with other nurses towards the realization of optimal results. They should be able to gauge the performance of their subordinates by reading their emotions. Finally, leadership is not only about applying what you have learned. Rather, it is about developing personal skills. Good personal skills combined with what I have discussed above will result in the best performance.

Barker, M., & DeNisco, S. M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession . Boston: Jones & Bartlett.

Cassady, J., & Eissa, A. (2008). Emotional intelligence: Perspective from educational and positive psychology . New York: Peter Lang.

Lauby, S. (2004). 7 Types of Power in the Workplace. Web.

Lieberman, S. (2015). Differences in Male and Female Communication Styles. Web.

Manojlovich, M. (2007). Power and Empowerment in Nursing: Looking Backward to Inform the Future. Web.

McCartney, P. (2004). Leadership in nursing informatics. Journal of Obstet Gynecol Neonatal Nurses , 33 (3), 371-380.

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IvyPanda. (2022, May 19). Nursing Leadership and Personal Skills.

"Nursing Leadership and Personal Skills." IvyPanda , 19 May 2022,

IvyPanda . (2022) 'Nursing Leadership and Personal Skills'. 19 May.

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IvyPanda . "Nursing Leadership and Personal Skills." May 19, 2022.

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  • Comparing Philosophies and Missions in Nursing
  • The Comfort Theory of Nursing Used in Education

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Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011.

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The Future of Nursing: Leading Change, Advancing Health.

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5 Transforming Leadership

Key Message #3 : Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

Strong leadership is critical if the vision of a transformed health care system is to be realized. Yet not all nurses begin their career with thoughts of becoming a leader. 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 profes sionals and be accountable for their own contributions to delivering high-quality care while working collaboratively with leaders from other health professions.

In addition to changes in nursing practice and education, discussed in Chapters 3 and 4 , respectively, strong leadership will be required to realize the vision of a transformed health care system. Although the public is not used to viewing nurses as leaders, and not all nurses begin their career with thoughts of becoming a leader, all nurses must be leaders in the design, implementation, and evaluation of, as well as advocacy for, the ongoing reforms to the system that will be needed. Additionally, nurses will need leadership skills and competencies to act as full partners with physicians and other health professionals in redesign and reform efforts across the health care system. Nursing research and practice must continue to identify and develop evidence-based improvements to care, and these improvements must be tested and adopted through policy changes across the health care system. Nursing leaders must translate new research findings to the practice environment and into nursing education and from nursing education into practice and policy.

Being a full partner transcends all levels of the nursing profession and requires leadership skills and competencies that must be applied both within the profession and in collaboration with other health professionals. In care environments, being a full partner involves taking responsibility for identifying problems and areas of waste, devising and implementing a plan for improvement, tracking improvement over time, and making necessary adjustments to realize established goals. Serving as strong patient advocates, nurses must be involved in decision making about how to improve the delivery of care.

Being a full partner translates more broadly to the health policy arena. To be effective in reconceptualized roles and to be seen and accepted as leaders, nurses must see policy as something they can shape and develop rather than something that happens to them, whether at the local organizational level or the national level. They must speak the language of policy and engage in the political process effectively, and work cohesively as a profession. Nurses should have a voice in health policy decision making, as well as being engaged in implementation efforts related to health care reform. Nurses also should serve actively on advisory committees, commissions, and boards where policy decisions are made to advance health systems to improve patient care. Nurses must build new partnerships with other clinicians, business owners, philanthropists, elected officials, and the public to help realize these improvements.

This chapter focuses on key message #3 set forth in Chapter 1 : Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States. The chapter begins by considering the new style of leadership that is needed. It then issues a call to nurses to respond to the challenge. The third section describes three avenues—leadership programs for nurses, mentorship, and involvement in the policy-making process—through which that call can be answered. The chapter then issues a call for new partnerships to tap the full potential of nurses to serve as leaders in the health care system. The final section presents the committee’s conclusions regarding the need to transform leadership in the nursing profession.


Those involved in the health care system—nurses, physicians, patients, and others—play increasingly interdependent roles. Problems arise every day that do not have easy or singular solutions. Leaders who merely give directions and expect them to be followed will not succeed in this environment. What is needed is a style of leadership that involves working with others as full partners in a context of mutual respect and collaboration. This leadership style has been associated with improved patient outcomes, a reduction in medical errors, and less staff turnover (Gardner, 2005; Joint Commission, 2008; Pearson et al., 2007). It may also reduce the amount of workplace bullying and disruptive behavior, which remains a problem in the health care field (Joint Commission, 2008; Olender-Russo, 2009; Rosenstein and O’Daniel, 2008). Yet while the benefits of collaboration among health professionals have repeatedly been documented with respect to improved patient outcomes, reduced lengths of hospital stay, cost savings, increased job satisfaction and retention among nurses, and improved teamwork, interprofessional collaboration frequently is not the norm in the health care field. Changing this culture will not be easy.

The new style of leadership that is needed flows in all directions at all levels. Everyone from the bedside to the boardroom must engage colleagues, subordinates, and executives so that together they can identify and achieve common goals (Bradford and Cohen, 1998). All members of the health care team must share in the collaborative management of their practice. Physicians, nurses, and other health professionals must work together to break down the walls of hierarchal silos and hold each other accountable for improving quality and decreasing preventable adverse events and medication errors. All must display the capacity to adapt to the continually evolving dynamics of the health care system.

Leadership Competencies

Nurses at all levels need strong leadership skills to contribute to patient safety and quality of care. Yet their history as a profession dominated by females can make it easier for policy makers, other health professionals, and the public to view nurses as “functional doers”—those who carry out the instructions of others—rather than “thoughtful strategists”—those who are informed decision makers and whose independent actions are based on education, evidence, and experience. A 2009 Gallup poll of more than 1,500 national opinion leaders, 1 “Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions,” identified nurses as “one of the most trusted sources of health information” (see Box 5-1 ) (RWJF, 2010a). The Gallup poll also identified nurses as the health professionals that should have greater influence than they currently do in the critical areas of quality of patient care and safety. The leaders surveyed believed that major obstacles prevent nurses from being more influential in health policy decision making. These findings have crucial implications for front-line nurses, who possess critical knowledge and awareness of the patient, family, and community but do not speak up as often as they should.

Results of Gallup Poll “Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions”. Opinion leaders rate doctors and nurses first and second among a list of options for trusted information about health and health (more...)

To be more effective leaders and full partners, nurses need to possess two critical sets of competencies: a common set that can serve as the foundation for any leadership opportunity and a more specific set tailored to a particular context, time, and place. The former set includes, among others, knowledge of the care delivery system, how to work in teams, how to collaborate effectively within and across disciplines, the basic tenets of ethical care, how to be an effective patient advocate, theories of innovation, and the foundations for quality and safety improvement. These competencies also are recommended by the American Association of Colleges of Nursing as essential for baccalaureate programs (AACN, 2008). Leadership competencies recommended by the National League for Nursing and National League for Nursing Accrediting Commission are being revised to reflect similar principles. More specific competencies might include learning how to be a full partner in a health team in which members from various professions hold each other accountable for improving quality and decreasing preventable adverse events and medication errors. Additionally, nurses who are interested in pursuing entrepreneurial and business development opportunities need competencies in such areas as economics and market forces, regulatory frameworks, and financing policy.

Leadership in a Collaborative Environment

As noted in Chapter 1 , a growing body of research has begun to highlight the potential for collaboration among teams of diverse individuals from different professions (Paulus and Nijstad, 2003; Pisano and Verganti, 2008; Singh and Fleming, 2010; Wuchty et al., 2007). Practitioners and organizational leaders alike have declared that collaboration is a key strategy for improving problem solving and achieving innovation in health care. Two nursing researchers who have studied collaboration among health professionals define it as

a communication process that fosters innovation and advanced problem solving among people who are of different disciplines, organizational ranks, or institutional settings [and who] band together for advanced problem solving [in order to] discern innovative solutions without regard to discipline, rank, or institutional affiliation [and to] enact change based on a higher standard of care or organizational outcomes. (Kinnaman and Bleich, 2004)

Much of what is called collaboration is more likely cooperation or coordination of care. Katzenbach and Smith (1993) argue that truly collaborative teams differ from high-functioning groups that have a defined leader and a set direction, but in which the dynamics of true teamwork are absent. The case study presented in Box 5-2 illustrates just how important it is for health professionals to work in teams to ensure that care is accessible and patient centered.

Case Study: Arkansas Aging Initiative. A Statewide Program Uses Interprofessional Teams to Improve Access to Care for Older Arkansans B onnie Sturgeon was an independent 80-year-old in 2005 when shortness of breath began to slow her down. She had been (more...)

Leadership at Every Level

Leadership from nurses is needed at every level and across all settings. Although collaboration is generally a laudable goal, there are many times when nurses, for the sake of delivering exceptional patient and family care, must step into an advocate role with a singular voice. At the same time, effective leadership also requires recognition of situations in which it is more important to mediate, collaborate, or follow others who are acting in leadership roles. Nurses must understand that their leadership is as important to providing quality care as is their technical ability to deliver care at the bedside in a safe and effective manner. They must lead in improving work processes on the front lines; creating new integrated practice models; working with others, from organizational policy makers to state legislators, to craft practice policy and legislation that allows nurses to work to their fullest capacity; leading curriculum changes to prepare the nursing workforce to meet community and patient needs; translating and applying research findings into practice and developing functional models of care; and serving on institutional and policy-making boards where critical decisions affecting patients are made.

Leadership in care delivery is particularly important in community and home settings where nurses work more autonomously with patients and families than they do in the acute care setting. In community and home settings, nurses provide a direct link connecting patients, their caregivers, and other members of the health care team. Other members of the health care team may not have the time, expertise, or first-hand experience with the patient’s home environment and circumstances to understand and respond to patient and family needs. For example, a neurologist may not be able to help a caregiver of an Alzheimer’s patient understand or curtail excessive spending habits, or a surgeon may not be able to offer advice to a caregiver on ostomy care—roles that nurses are perfectly positioned to assume. Leadership in these situations sometimes requires nurses to be assertive and to have a strong voice in advocating for patients and their families to ensure that their needs are communicated and adequately met.

Box 5-3 describes a nurse who evolved over the course of her career from thinking that being an effective nurse was all about honing her nursing skills and competencies to realize that becoming an agent of change was an equally important part of her job.

Nurse Profile: Connie Hill. A Nurse Leader Extends Acute Care Nursing Beyond the Hospital Walls I t was at a 2002 meeting at Children’s Memorial Hospital in Chicago that Connie Hill, MSN, RN, reviewed the chart of a child who had been on a ventilator (more...)


Leadership does not occur in a social or political vacuum. As Bennis and Nanus (2003) note, the fast pace of change can be managed only if it is accompanied by leaders who can track the context of the “social architecture” to sustain and implement innovative ideas. Creating innovative care models at the bedside and in the community or taking the opportunity to fill a seat in a policy-making body or boardroom requires nurse leaders to develop ideas; approach management; and courageously make decisions within the political, economic, and social context that will make their solutions real and sustainable. A shift must take place in how nurses view their responsibility to those they care for; they must see themselves as full partners with other health professionals, and practice and education environments must socialize and educate them accordingly.

An important aspect of this socialization is mentoring others along the way. More experienced nurses must take the time to show those who are new and less experienced the most effective ways of being an exceptional nurse at the bedside, in the boardroom, and everywhere between. Technology such as chat rooms, Facebook, and even blogs can be used to support the mentoring role.

A crucial part of working within the social architecture is understanding how leadership and practice produce change over time. The nursing profession’s history includes many examples of the effect of nursing leadership on changes in systems and improvements in patient care. In the late 1940s and early 1950s, nurse Elizabeth Carnegie led the fight for the racial integration of nursing in Florida by example and through her extraordinary character and organizational skills. Her efforts to integrate the nursing profession were based in her sense of social justice not just for the profession, but also for the care of African American citizens who had little access to a workforce that was highly skilled or provided adequate access to health care services. Also in Florida, in the late 1950s, Dorothy Smith, the first dean of the new University of Florida College of Nursing, developed nursing practice models that brought nursing faculty into the hospital in a joint nursing service. Students thereby had role models in their learning experiences, and staff nurses had the authority to improve patient care. From this system came the patient kardex and the unit manager system that freed nurses from the constant search for supplies that took them away from the bedside. In the 1980s, nursing research by Neville Strumpf and Lois Evans highlighted the danger of using restraints on frail elders (Evans and Strumpf, 1989; Strumpf and Evans, 1988). Their efforts to translate their findings into practice revolutionized nursing practice in nursing homes, hospitals, and other facilities by focusing nursing care on preventing falls and other injuries related to restraint use, and led to state and federal legislation that resulted in reducing the use of restraints on frail elders.

Nurses also have also led efforts to improve health and access to care through entrepreneurial endeavors. For example, Ruth Lubic founded the first free-standing birth center in the country in 1975 in New York City. In 2000, she opened the Family Health and Birth Center in Washington, DC, which provides care to underserved communities (see Box 2-2 in Chapter 2 ). Her efforts have improved the care of thousands of women over the years. There are many other examples of nurse entrepreneurs, and a nurse entrepreneur network 2 exists that provides networking, education and training, and coaching for nurses seeking to enter the marketplace and business.

Will Student Nurses Hear the Call?

Leadership skills must be learned and mastered over time. Nonetheless, it is important to obtain a basic grasp of those skills as early as possible—starting in school (see Chapter 4 ). Nursing educators must give their students the most relevant knowledge and practice opportunities to equip them for their profession, while instilling in them a desire and expectation for new learning in the years to come. Regardless of the basic degree with which a nurse enters the profession, faculty should feel obligated to show students the way to their first or next career placement, as well as to their next degree and continuous learning opportunities.

Moreover, students should not wait for graduation to exercise their potential for leadership. In Georgia, for example, health students came together in 2001 under the banner “Lead or Be Led” to create a student-led, interprofessional nonprofit organization that “seeks to make being active in the health community a professional habit.” Named Health Students Taking Action Together (Health-STAT), the group continues to offer workshops in political advocacy, media training, networking, and fundraising. Its annual leadership symposium convenes medical, nursing, public health, and other students statewide to learn about health issues facing the state and work together on developing potential solutions (HealthSTAT, 2010). The National Student Nurses Association (NSNA), initiated in 1998, offers an online Leadership University that allows students to enhance their capacity for leadership through several avenues, such as earning academic credit for participating in the university’s leadership activities and discussing leadership issues with faculty. Students work in cooperative relationships with other students from various disciplines, faculty, community organizations, and the public (Janetti, 2003). Box 5-4 profiles two student leaders, one of whom eventu ally became NSNA president; both represent as well the growing diversity of the nursing profession, a crucial need if the profession is to rise to the challenge of helping to transform the health care system (see Chapter 4 ).

Nurse Profile: Kenya D. Haney and Billy A. Caceres. Building Diversity in Nursing, One Student at a Time D espite improvements to thedemographic make up of the nursing workforce in recent decades, the workforce remains predominantly white, female, and (more...)

Looking to the future, nurse leaders will need the skills and knowledge to understand and anticipate population trends. Formal preparation of student nurses may need to go beyond what has traditionally been considered nursing education. To this end, a growing number of schools offer dual undergraduate degrees in partnership with the university’s business or engineering school for nurses interested in starting their own business or developing more useful technology. Graduate programs offering dual degree programs with schools of business, public health, law, design, or communications take this idea one step further to equip students with an interest in administrative, philanthropic, regulatory, or policy-making positions with greater competencies in management, finance, communication, system design, or scope-of-practice regulations from the start of their careers.

Will Front-Line Nurses Hear the Call?

Given their direct and sustained contact with patients, front-line nurses, along with their unit or clinic managers, are uniquely positioned to design new models of care to improve quality, efficiency, and safety. Tapping that potential will require developing a new workplace culture that encourages and supports leaders at the point of care (whether a hospital or the community) and requires all members of a health care team to hold each other accountable for the team’s performance; nurses must also be equipped with the communication, conflict resolution, and negotiating skills necessary to succeed in leadership and partnership roles. For example, one new quality and safety strategy requires checklists to be completed before certain procedures, such as inserting a catheter, are begun. Nurses typically are asked to enforce adherence to the checklist. If another nurse or a physician does not wash his/her hands or contaminates a sterile field, nurses must possess the basic leadership skills to remind their colleague of the protocol and stop the procedure, if necessary, until the checklist is followed. And again, nurses must help and mentor each other in their roles as expert clinicians and patient advocates. No one can build the capabilities of an exceptional and effective nurse like another exceptional and effective nurse.

Will Community Nurses Hear the Call?

Nurses working in the community have long understood that to be effective in contributing to improvements in the entire community’s health, they must assume the role of social change agent. Among other things, community and public health nurses must promote immunization, good nutrition, and physical activity; detect emergency health threats; and prevent and respond to outbreaks of communicable diseases. In addition, they need to be prepared to assume roles in dealing with public health emergencies, including disaster preparedness, response, and recovery. Recent declines in the numbers of community and public health nurses, however, have made the leadership imperative for these nurses much more challenging.

Community and public health nurses learn to expect the unexpected. For example, a school nurse alerted health authorities to the arrival of the H1N1 influenza virus in New York City in 2009 (RWJF, 2010c). Likewise, an increasing number of nurses are being trained in incident command as part of preparedness for natural disasters and possible terrorist attacks. This entails understanding the roles of and working with community, state, and federal officials to assure the health and safety of the public. For example, when the town of Chehalis, south of Seattle, experienced a 100-year flood in 2007, a public health nurse called the secretary of Washington State’s Department of Health, Mary Selecky, to ask how to “deal with and dispose of dead cows, an unforeseen challenge [for] a public health nurse. The nurse knew she needed [to provide] tetanus shots and portable toilets but had not anticipated other, less common, aspects of the emergency” (IOM, 2010).

The profile in Box 5-5 illustrates how nurses lead efforts that provide critical services for communities. The profile also shows how nurses can also become leaders and social change agents in the broader community by serving on the boards of health-related institutions. The importance of this role is discussed in the next section.

Nurse Profile: Mary Ann Christopher. Cultivating Neighborhood Nursing at the Visiting Nurse Association of Central Jersey A t the Visiting Nurse Association of Central Jersey (VNACJ), president and chief executive officer Mary Ann Christopher, MSN, RN, (more...)

Will Chief Nursing Officers Hear the Call?

Although chief nursing officers (CNOs) typically are part of the hierarchical decision-making structure in that they have authority and responsibility for the nursing staff, they need to move up in the reporting structure of their organizations to increase their ability to contribute to key decisions. Not only is this not happening, however, but CNOs appear to be losing ground. A 2002 survey by the American Organization of Nurse Executives (AONE) showed that 55 percent of CNOs reported directly to their institution’s CEO, compared with 60 percent in 2000. More CNOs described a direct reporting relationship to the chief operating officer instead. Such changes in reporting structure can limit nurse leaders’ involvement in decision making about the most important product of hospitals—patient care. Additionally, the AONE survey showed that most CNOs (70 percent) have seen their responsibilities increase even as they have moved down in the reporting structure (Ballein Search Partners and AONE, 2003). CNOs face growing issues of contending not only with increased responsibilities, but also with budget pressures and difficulties with staffing, retention, and turnover levels during a nursing shortage (Jones et al., 2008).

Nurses also are underrepresented on institution and hospital boards, either their own or others. A biennial survey of hospitals and health systems conducted in 2007 by the Governance Institute found that only 0.8 percent of voting board members were CNOs, compared with 5.1 percent who were vice presidents for medical affairs (Governance Institute, 2007). More recently, a 2009 survey of community health systems found that nurses made up only 2.3 percent of their boards, compared with 22.6 percent who were physicians (Prybil et al., 2009). 3 While most boards focus mainly on finance and business, health care delivery, quality, and responsiveness to the public—areas in which the nature of their work gives nurses particular expertise—also are considered key (Center for Healthcare Governance, 2007). A 2007 survey found that 62 percent of boards included a quality committee (Governance Institute, 2007). A 2006 survey of hospital presidents and CEOs showed the impact of such committees. Those institutions with a quality committee were more likely to adopt various oversight practices; they also experienced lower mortality rates for six common medical conditions measured by the Agency for Healthcare Research and Quality’s (AHRQ’s) Inpatient Quality Indicators and the State Inpatient Databases (Jiang et al., 2008).

The growing attention of hospital boards to quality and safety issues reflects the increased visibility of these issues in recent years. Several states and the Centers for Medicare and Medicaid Services, for example, are increasing their oversight of specific preventable errors (“never events”), and new payment structures in health care reform may be based on patient outcomes and satisfaction (Hassmiller and Bolton, 2009; IOM, 2000; King, 2009; Wachter, 2009). Given their expertise in quality and safety improvement, nurses are more likely than many other board members to understand the issues involved and often can educate other members about these issues (Mastal et al., 2007). This is one area, then, in which nurse board members can have a significant impact. Recognizing this, the 2009 survey of community health systems mentioned above specifically recommended that community health system boards consider appointing expert nursing leaders as voting board members to strengthen clinical input in deliberations and decision-making processes (Prybil et al., 2009).

More CNOs need to prepare themselves and seek out opportunities to serve on the boards of health-related institutions. If decisions are taking place about patient care and a nurse is not at the decision-making table, important perspectives will be missed. CNOs should also promote leadership activities among their staff, encouraging them to secure important decision-making positions on committees and boards, both internal and external to the organization.

Will Nurse Researchers Hear the Call?

Nurse researchers must develop new models of quality care that are evidence based, patient centered, affordable, and accessible to diverse populations. Developing and imparting the science of nursing is also an important contribution to nurses’ ability to deliver high-quality, safe care. Additionally, nurses must serve as advocates and implementers for the program designs they develop. Academic–service partnerships that typically involve nursing schools and nearby, often low-income communities are a first step toward implementation. Given that a nursing school does not exist in every community, however, such partnerships cannot achieve change on the scale needed to transform the health care system. Nurse researchers must become active not only in studying important care deliv ery questions but also in translating research findings into practice and developing and setting the policy agendas. Their leadership is vital in ensuring that new state-and federal-level policies are based on evidence and will help increase quality and access while decreasing costs and health care disparities. The Affordable Care Act (ACA) provides opportunities for demonstration projects and pilot programs directed at various elements of nursing. If these projects and programs do not adequately track nursing inputs and intended/unintended outcomes, they cannot hope to achieve their potential.

Nurse researchers should seek funding from the National Institute for Nursing Research and other institutes of the National Institutes of Health, as do scientists from other disciplines, to help increase the evidence base for improved models of care. Funding might also be secured from other government entities, such as AHRQ and the Health Resources and Services Administration (HRSA) and local and national foundations, depending on the research topic. To be competitive in these efforts, nurses should hone their analytical skills with training in such areas as statistics and data analysis, econometrics, biometrics, and other qualitative and quantitative research methods that are appropriate to their research topics. Mark Pauly, codirector of the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative, argues that, for nursing research to achieve parity with other health services research in terms of acceptability, it must be managed by interprofessional teams that include both nurse scholars and scholars from methodological and modeling disciplines. For nurse researchers to achieve parity with other health services researchers, they must develop the skills and initiative to take leadership roles in this research. 4

Will Nursing Organizations Hear the Call?

The Gallup poll of 1,500 opinion leaders referenced earlier in this chapter also highlighted fragmentation in the leadership of nursing organizations as a challenge. Responding opinion leaders predicted that nurses will have little influence on health care reform over the next 5–10 years (see Figure 5-1 ). By contrast, they believed that nurses should have more input and impact in areas such as planning, policy development, and management ( Figure 5-2 ) (RWJF, 2010a). No one expects all professional health organizations to coordinate their public agendas, actions, or messaging for every issue. But nursing organizations must continue to collaborate and work hard to develop common messages, including visions and missions, with regard to their ability to offer evidence-based solutions for improvements in patient care. Once common ground has been established, nursing organizations will need to activate their membership and constituents to work together to take action and support shared goals. When policy makers and other key decision makers know that the largest group of health professionals in the country is in agreement on important issues, they listen and often take action. Conversely, when nursing organizations and their members disagree with one another on important issues, decisions are not made, as the decision makers often are unsure of which side to take.

Opinion leaders’ predictions of the amount of influence nurses will have on health care reform. NOTE: Govt. = Government; Ins. Execs. = Insurance executives; Pharma. execs. = Pharmaceutical executives; HC execs. = Health care executives.

Opinion leaders’ views on the amount of influence nurses should have on various areas of health care. SOURCE: RWJF, 2010b. Reprinted with permission from Frederick Mann, RWJF.

Quality and safety are important areas in which professional nursing organizations have great potential to serve as leaders. The Nursing Alliance for Quality Care (NAQC) 5 is a Robert Wood Johnson Foundation–funded effort with the mission of advancing the quality, safety, and value of patient-centered health care for all individuals, including patients, their families, and the communities where patients live. Based at the George Washington University School of Nursing, the organization stresses the need for nurses to advocate actively for and be accountable to patients for high-quality and safe care. The establishment of the NAQC “is based on the assumption that only with a stronger, more unified ‘voice’ in nursing policy will dramatic and sustainable achievements in quality and safety be achieved for the American public” (George Washington University Medical Center, 2010).


The call for nurses to assume leadership roles can be answered through leadership programs for nurses; mentorship; and involvement in the policy-making process, including political engagement.

Leadership Programs for Nurses

Leadership is not necessarily innate; many individuals develop into leaders. Sometimes that development comes through experience. For example, nurse leaders at the executive level historically earned their way to their position through their competence, rather than obtaining formal preparation through a business school. However, development as a leader can also be achieved through more formal education and training programs. The wide range of effective leadership programs now available for nurses is illustrated by the examples described below. The challenge is to better utilize these opportunities to develop a greater number of nursing leaders.

Integrated Nurse Leadership Program

The Integrated Nurse Leadership Program (INLP), 6 funded by the Gordon and Betty Moore Foundation, works with hospitals in the San Francisco Bay area that wish to remodel their professional culture and systems of care to improve care while dealing more effectively with continual change. The program develops hospital leaders, offers training and technical assistance, and provides grants to support the program’s implementation. INLP has found that the development of stable, effective leadership in nursing-related care is associated with better-than-expected patient care outcomes and improvements in nurse recruitment and retention. The impact of the program will be evaluated to produce models that can be replicated in other parts of the country.

Fellows Program in Management for Nurse Executives at Wharton 7

When the Johnson & Johnson Company and the Wharton School joined in 1983 to offer a senior nurse executive management fellowship, the program concentrated on helping senior nursing leaders manage their departments by providing them, for example, intense training in accounting (Shea, 2005). The Wharton Fellows program has changed in many ways since then in response to the evolving health care environment, according to a 2005 review (Shea, 2005). For example, the program has strengthened senior nursing executives’ ability to argue for quality improvement on the basis of solid evidence, including financial documentation and probabilistic decision making. The program also aims to improve such leadership competencies as systems thinking, negotiation, communications, strategy, analysis, and the development of learning communities. Its offerings will likely undergo yet more changes as hospital chief executive and chief operating officers increasingly come from the ranks of the nursing profession.

Robert Wood Johnson Foundation Executive Nurse Fellows Program

The Robert Wood Johnson Foundation Executive Nurse Fellows Program 8 is an advanced leadership program for nurses in senior executive roles who wish to lead improvements in health care from local to national levels. It provides a 3-year in-depth, comprehensive leadership development experience for nurses who are already serving in senior leadership positions. The program is designed to cultivate and expand fellows’ capacity to lead teams and organizations. The fellowship program includes curriculum and program activities that provide opportunities for executive coaching and mentoring, team-based and individual leadership projects, professional development that incorporates best practices in leadership, as well as access to online communities and leadership networks. Through the program, fellows master 20 leadership competencies that cover a broad range of knowledge and skills that can be used when “leading self, leading others, leading the organization and leading in health care” (RWJF Executive Nurse Fellows, 2010).

Best on Board

Best on Board 9 is an education, testing, and certification program that helps prepare current and prospective leaders to serve on the governing board of a health care organization. Its CEO, Connie Curran, is a registered nurse (RN) who chaired a hospital nursing department, was the dean of a medical college, and founded her own national management and consulting services firm. A 2010 review cites the growing recognition by blue ribbon panels and management researchers that nurses are an untapped resource for the governing bodies of health care organizations. The authors argue that while nurses have many qualities that make them natural assets to any health care board, they must also “understand the advantages of serving on boards and what it takes to get there” (Curran and Totten, 2010).

Robert Wood Johnson Foundation Health Policy Fellows and Investigator Awards Programs

While not limited to nurses, the Robert Wood Johnson Foundation Health Policy Fellows and Investigator Awards programs 10 offer nurses, other health professionals, and behavioral and social scientists “with an interest in health [the opportunity] to participate in health policy processes at the federal level” (RWJF Scholars, Fellows & Leadership Programs, 2010). Fellows work on Capitol Hill with elected officials and congressional staff. The goal is for fellows to use their academic and practice experience to inform the policy process and to improve the quality of policies enacted. Investigators are funded to complete innovative studies of topics relevant to current and future health policy. Participants in both programs receive intensive training to improve the content and delivery of messages intended to improve health policy and practice. This training is critical, as investigators are often called upon to testify to Congress about the issues they have explored. The health policy fellows bring their more detailed understanding of how policies are formed back to their home organizations. In this way, they are more effective leaders as they strive to bring about policy changes that lead to improvements in patient care.

American Nurses Credentialing Center Magnet Recognition Program

Although not an individual leadership program, the American Nurses Credentialing Center (ANCC) Magnet Recognition Program 11 recognizes health care organizations that advance nursing excellence and leadership. In this regard, achieving Magnet status indicates that the nursing workforce within the institution has attained a number of high standards relating to quality and standards of nursing practice. These standards, as designated by the Magnet process, are called “Forces of Magnetism.” According to ANCC, “the full expression of the Forces embodies a professional environment guided by a strong visionary nursing leader who advocates and supports development and excellence in nursing practice. As a natural outcome of this, the program elevates the reputation and standards of the nursing profession” (ANCC, 2010). Some of these Forces include quality of nursing leadership, management style, quality of care, autonomous nursing care, nurses as teachers, interprofessional relationships, and professional development.

Mentorship 12

Leadership is also fostered through effective mentorship opportunities with leaders in nursing, other health professions, policy, and business. All nurses have a responsibility to mentor those who come after them, whether by helping a new nurse become oriented or by taking on more formal responsibilities as a teacher of nursing students or a preceptor. Nursing organizations (membership associations) also have a responsibility to provide mentoring and leadership guidance, as well as opportunities to share expertise and best practices, for those who join.

Fortunately, a number of nursing associations have organized networks to support their membership and facilitate such opportunities:

  • The American Association of Colleges of Nursing (AACN) conducts an expertise survey that is used to identify subject matter experts across topic areas within its membership; it also maintains a list of nursing education experts. Names of these experts are shared with members on request. These resources also are used to identify experts to serve on boards, respond to media requests, and serve in other capacities. In addition, AACN offers an annual executive leadership development program and a new deans mentoring program to further promote and foster leadership.
  • The National League for Nursing (NLN) has established an Academy of Nurse Educators whose members are available to serve as mentors for NLN members. NLN engages these educators in a variety of mentoring programs, from a National Scholarly Writing Retreat to the Johnson & Johnson mentoring program for new faculty.
  • While AONE does not have a formal mentoring program, it has developed online learning communities where members are encouraged to interact, post questions, and learn from each other. These online communities facilitate collaboration; encourage the sharing of knowledge, best practices, and resources; and help members discover solutions to day-to-day challenges in their work.
  • The American Academy of Nursing keeps a detailed list of nurse “Edge Runners” 13 that describes the programs nursing leaders have developed and the outcomes of those programs. Edge Runner names and contact information are prominently displayed so that learning and mentoring can take place freely. 14
  • The American Nurses Association just passed a resolution at its 2010 House of Delegates to develop a mentoring program for novice nurses. The program has yet to be developed.
  • Over the years, the National Coalition of Ethnic Minority Nurse Associations (NCEMNA) has offered numerous workshops, webinars, and educational materials to develop its members’ competencies in leadership, policy, and communications. NCEMNA’s highly regarded Scholars program 15 promotes the academic and professional development of ethnic minority investigators, in part through a mentoring program. It serves as a model worth emulating throughout the nursing profession.

Involvement in Policy Making

Nurses may articulate what they want to happen in health care to make it more truly patient centered and to improve quality, access, and value. They may even have the evidence to support their conclusions. As with any worthy cause, however, they must engage in the policy-making process to ensure that the changes they believe in are realized. To this end, they must be able to envision themselves as leaders in that process and seek out new partners who share their goals.

The challenge now is to motivate all nurses to pursue leadership roles in the policy-making process. Political engagement is one avenue they can take to that end. As Bethany Hall-Long, a nurse who was elected to the Delaware State House of Representatives in 2002 and is now a state senator, writes, “political actions may be as simple as voting in local school board elections or sharing research findings with state officials, or as complex as running for elected office” (Hall-Long, 2009). For example, engaging school board candidates about the fundamental role of school nurses in the management of chronic conditions among students can make a difference at budget time. And if the goal is broader, perhaps to locate more community health clinics within schools, achieving buy-in from the local school board is absolutely vital. As Hall-Long writes, however, “since nurses do not regularly communicate with their elected officials, the elected officials listen to non-nursing individuals” (Hall-Long, 2009).

Political engagement can be a natural outgrowth of nursing experience. When Marilyn Tavenner first started working in an intensive care unit in Virginia, she thought, “If I were the head nurse or the nurse manager, I would make changes. I would try to influence that unit and that unit’s quality and staffing.” After she became a nurse manager, she thought, “I wouldn’t mind doing this for the entire hospital.” After succeeding for several years as a director of nursing, she was encouraged by a group of physicians to apply for the CEO position of her hospital when it became available. Eventually, Timothy Kaine, governor of Virginia from 2006 to 2010, recruited her to be the state’s secretary of health and human resources. In February 2010, Ms. Tavenner was named deputy administrator for the federal Centers for Medicare and Medicaid Services. Like many nurses, she had never envisioned working in government. But she realized that she wanted to have an impact on health care and health care reform. She wanted to help the uninsured find resources and access to care. For her, that meant building on relationships and finding opportunities to work in government. 16

Other notable nurses who have answered the call to serve in government include Sheila Burke, who served as chief of staff to former Senate Majority Leader Robert Dole, has been a member of the Medicare Payment Advisory Commission, and now teaches at Georgetown and Harvard Universities; and Mary Wakefield, who was named administrator of HRSA in 2009 and is the highest-ranking nurse in the Obama Administration. Speaker of the House Nancy Pelosi’s office has had back-to-back nurses from The Robert Wood Johnson Foundation Health Policy Fellows Program as staffers since 2007, providing a significant entry point for the development of new health policy leaders. Additionally, in 1989 Senator Daniel Inouye established the Military Nurse Detailee fellowship program. This 1-year fellowship provides an opportunity for a high-ranking military nurse, who holds a minimum of a master’s degree, to gain health policy leadership experience in Senator Inouye’s office. The fellowship rotates among three branches of service (Army, Navy, and Air Force) annually. 17 During the Clinton Administration, Beverly Malone served as deputy assistant secretary for health in the Department of Health and Human Services (HHS). In 2002, Richard Carmona, who began his education with an associate’s degree in nursing from the Bronx Community College in New York, was appointed surgeon general by President George W. Bush. Shirley Chater led the reorganization of the Social Security Administration in the 1990s. Carolyne Davis served as head of the Health Care Finance Administration (predecessor of the Centers for Medicare and Medicaid Services) in the 1980s during the implementation of a new coding system that classifies hospital cases into diagnosis-related groups. From 1979 to 1981, Rhetaugh Dumas was the first nurse, the first woman, and the first African American to serve as a deputy director of the National Institute of Mental Health (Sullivan, 2007). Nurses also have served as regional directors of HHS and as senior advisors on health policy to HHS.

As for elected office, there were three nurse members of the 111th Congress—Eddie Bernice Johnson (D-TX), Lois Capps (D-CA), and Carolyn McCarthy (D-NY)—all of whom had a hand in sponsoring and supporting health care–focused legislation, from AIDS research to gun control. Lois Capps organized and co-chairs the Congressional Nursing Caucus (which also includes members who are not nurses). The group focuses on mobilizing congressional support for health-related issues. Additionally, 105 nurses have served in state legislatures, including Paula Hollinger of Maryland, who sponsored one of the nation’s first stem cell research bills. None of these nurses waited to be asked; they pursued their positions, both elected and appointed, because they knew they had the expertise and experience to make changes in health care.

Very little in politics is accomplished without preparation or allies. Health professionals point with pride to multiple aspects of the Prescription for Pennsylvania initiative, a state health care reform initiative that preceded the ACA and is also described in Box 5-6 . As is clear from a detailed 2009 review, success was not achieved overnight; smaller legislative and regulatory victories set the stage starting in the late 1990s. Even some apparent legislative failures built the foundation for future successes because they caused nurses to spend more time meeting face to face with physicians who had organized opposition to various measures. As a result, nursing leaders developed a better sense of where they could achieve compromises with their opponents. They also found a new ally in the Chamber of Commerce to counter opposition from some sections of organized medicine (Hansen-Turton et al., 2009).

Case Study: Prescription for Pennsylvania. A Governor’s Leadership Improves Access to Care for Residents of a Rural State W hen Pennsylvania Governor Edward Rendell took office in 2003, one-twelfth of the state’s 12 million residents had (more...)

Hansen-Turton and colleagues draw three major lessons from this experience. First, nurses must build strong alliances within their own professional community, an important lesson alluded to earlier in this chapter. Pennsylvania’s nurses were able to speak with a unified voice because they first worked out among themselves which issues mattered most to them. Second, nurses must build relationships with key policy makers. Pennsylvania’s nurses developed strong relationships with several legislators from both major political parties and earned the support of two successive sitting governors: Thomas Ridge (Republican) and Edward Rendell (Democrat). Third, nurses must find allies outside the nursing profession, particularly in business and other influential communities. Pennsylvania’s nurses gained a strong ally in the Chamber of Commerce when they were able to demonstrate how expanding regulations to allow nurses to do all they were educated and demonstrably capable of doing would help lower health care costs (Hansen-Turton et al., 2009).

Perhaps the most important lesson to draw from the Pennsylvania experience lies in the way the campaign was framed. The focus of attention was on achieving quality care and cost reductions. A closer examination of the issues showed that achieving those goals required, among other things, expanding the roles and responsibilities of nurses. What drew the greatest amount of political support for the Prescription for Pennsylvania campaign was the shared goal of getting more value out of the health care system—quality care at a sustainable price. The fact that the campaign also expanded nursing practice was secondary. Those expansions are likely to continue as long as the emphasis is on quality care and cost reduction. Similarly, the committee believes that the goal in any transformation of the health care system should be achieving innovative, patient-centered, highvalue care. If all stakeholders—from legislators, to regulators, to hospital executives, to insurance companies—act from a patient-centered point of reference, they will see that many of the solutions they are seeking require a transformation of the nursing profession.


Having enough nurses and having nurses with the right skills and competencies to care for the population is an important societal issue. Having allies from outside the profession is important to achieving this goal. More nurses need to reach out to new partners in arenas ranging from business, government, and philanthropy to state and national medical associations to consumer groups. Additionally, nurses need to fortify alliances that are made through personal connections and relationships. Just as important, society needs to understand its stake in ensuring that nurses are effective full partners and leaders in the quest to deliver quality, high-value care that is accessible to diverse populations. The full potential of the nursing profession in care, leadership, and research must be tapped to deal with the wide range of health care challenges the nation will face in the coming years.

Eventually, to transform the way health care is delivered in the United States, nurses will have to move not just out of the hospital, but also out of health care organizations entirely. For example, nurses are underrepresented on the boards of private nonprofit and philanthropic organizations, which do not provide health care services but often have a large impact on health care decisions. The Commonwealth Fund and the Kaiser Family Foundation, for instance, have no nurses on their boards, although they do have physicians. Without nurses, vital ground-level perspectives on quality improvement, care coordination, and health promotion are likely missing. On the other hand, AARP provides a positive example. At least two nurses at AARP have served in the top leadership and governance roles (president and chair) in the past 3 years. Nurses serve on the health and long-term services policy committee, and the senior vice president of the Public Policy Institute is also a nurse. AARP’s commitment to nursing is clear through its sponsorship, along with the Robert Wood Johnson Foundation, of the Center to Champion Nursing.

Enactment of the ACA will provide unprecedented opportunities for change in the U.S. health care system for the foreseeable future. Strong leadership on the part of nurses, physicians, and others will be required to devise and implement the changes necessary to increase quality, access, and value and deliver patient-centered care. If these efforts are to be successful, all nurses, from students, to bedside and community nurses, to CNOs and members of nursing organizations, to researchers, must develop leadership competencies and serve as full partners with physicians and other health professionals in efforts to improve the health care system and the delivery of care. Nurses must exercise these competencies in a collaborative environment in all settings, including hospitals, communities, schools, boards, and political and business arenas. In doing so, they must not only mentor others along the way, but develop partnerships and gain allies both within and beyond the health care environment.

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Gallup research staff—Richard Blizzard, Christopher Khoury, and Coleen McMurray—conducted telephone surveys with 1,504 individuals, including university faculty, insurance executives, corporate executives, health services leaders, government leaders, and industry thought leaders.

See http://www ​.nurse-entrepreneur-network ​.com/public/main.cfm .

It should be noted that, while there are many more physicians than nurses on hospital boards, health care providers still are generally underrepresented.

Personal communication, Mark Pauly, Bendheim Professor, Professor of Health Care Management, Professor of Business and Public Policy, Professor of Insurance and Risk Management, and Professor of Economics, Wharton School of the University of Pennsylvania, and Codirector of the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative, June 25, 2010.

See http://www ​ ​/healthsci/departments/nursing/naqc/ .

See http://futurehealth ​.ucsf ​.edu/Public/Leadership-Programs ​/Home.aspx?pid=35 .

See http: ​//executiveeducation ​ ​/open-enrollment/health-care-programs ​/Fellows-Program-Management-Nurse-Executives.cfm .

See http://www ​ .

See http://www ​ .

See http://www ​.rwjfleaders ​.org/programs/robert-wood-johnson-foundation-health-policy-fellow .

See http://www ​.nursecredentialing ​.org/Magnet/ProgramOverview ​.aspx .

This section draws on personal communication in 2010 with Susan Gergely, Director of Operations, American Organization of Nurse Executives; Beverly Malone, CEO, National League for Nursing; Robert Rosseter, Chief Communications Officer, American Association of Colleges of Nursing; and Pat Ford Roegner, CEO, American Academy of Nursing.

The Edge Runner program is a component of the American Academy of Nursing’s Raise the Voice campaign, funded by the Robert Wood Johnson Foundation. The Edge Runner designation recognizes nurses who have developed innovative, successful models of care and interventions to address problems in the health care delivery system or unmet health needs in a population.

See AAN’s Edge Runner Directory, http://www ​ ​/custom/edgeRunner/index ​.cfm?pageid=3303&showTitle ​=1 .

See http://www ​ .

This paragraph draws on personal communication with Marilyn Tavenner, principal deputy administrator and chief operating officer, Centers for Medicare and Medicaid Services, May 11, 2010.

Personal communication, Corina Barrow, Lieutenant Colonel, Army Nurse Corps, Nurse Corps Detailee, Office of Senator Daniel Inouye (D-HI), August 25, 2010.

  • Cite this Page Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011. 5, Transforming Leadership.
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Politics latest: Rwanda plan suffers successive defeats in Lords - as Galloway criticised for 'repulsive' Holocaust comparison

The House of Lords has delivered a damning verdict on the government's flagship Rwanda deportation plan. Meanwhile, firebrand George Galloway is back in Westminster after being sworn in as Rochdale's MP - and Jeremy Hunt is hinting at tax cuts in this week's budget.

Monday 4 March 2024 21:50, UK

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  • Galloway criticised for Holocaust remark
  • Corbyn launches legal action against Farage
  • Lords deals successive blows to Rwanda plan
  • Explained: What's happened in the Lords tonight
  • Budget 2023 : What to expect  | How to watch  | Why Hunt's willing to sacrifice public spending |  Podcast: Are tax cuts a vote winner?
  • Live reporting by Ben Bloch and (earlier)  Faith Ridler

Following the Rochdale by-election, Sky’s political editor Beth Rigby, the Labour MP for Birmingham Yardley, Jess Phillips, and former leader of the Scottish Conservatives, Ruth Davidson, discuss what George Galloway’s win means for parliament. 

They examine the fallout from the by-election and ask why politics is not working for many people. 

They also look ahead to this week's budget – predicting what Chancellor Jeremy Hunt might pull out of the bag. 

A thought-provoking conversation with a healthy dose of fun. 

Email Beth, Ruth, and Jess at [email protected], Tweet Beth @BethRigby, or send a WhatsApp voice note on 07934 200 444. 

Warning: some explicit language. 

👉 Listen above then tap here to follow Electoral Dysfunction wherever you get your podcasts 👈

Earlier today, the new Rochdale MP, George Galloway, was sworn into parliament, after which he gave a news conference.

While taking questions from journalists, the controversial far-left MP reiterated that he intends to hold the feet of both the government and Labour to the fire over their positions on the Israel-Hamas war.

Mr Galloway also said he will "certainly work with the SNP to try and force a proper vote on a proper ceasefire", even though he disagrees with the party's position on Scottish independence.

Sky News approached the SNP to see if they would be willing to work with Mr Galloway, and they said they would.

A party spokesperson told Sky News: "The SNP will continue to use every opportunity we are afforded to press for an immediate ceasefire in Gaza and Israel, and lasting peace through a two-state solution.

"We hope MPs from across parliament will join us on the right side of history."

As the country gears up for the general election, Wednesday's budget may be the last before the voters go to the polls.

Hailed as "a budget to save the Tory party", speculation has been mounting that the chancellor will cut taxes as a last-ditch attempt to boost the Conservatives' plunging support.

To afford the move, funding to public services could be slashed - but Jeremy Hunt has insisted any cuts will be done "responsibly".

On today's episode, Sophy Ridge looks ahead to the budget. She's joined by deputy political editor Sam Coates and pollster Scarlett Maguire to unpack whether cutting taxes really is the way to a Conservative election win.

Click to subscribe to the Sky News Daily wherever you get your podcasts

When is the budget?

This spring budget is on Wednesday.

The budget is accompanied by economic and fiscal outlooks from the Office for Budget Responsibility (OBR), the independent public finances forecaster.

What time is the announcement?

Chancellor Jeremy Hunt will deliver the budget statement in the House of Commons.

The announcement usually starts at 12.30pm - directly after Prime Minister's Questions - and lasts about an hour.

Labour leader Sir Keir Starmer will give his response as soon as the speech is over.

Before the announcement, the chancellor poses for the press with the red despatch box containing the budget papers.

How can I watch and follow the announcements?

You can follow all the key announcements in the Politics Hub here.

You can also watch the event live on Sky News on Sky channel 501, Virgin 602, and Freeview 233.

If you want to watch on YouTube, watch the Sky News live channel here.

What is included in the budget?

The budget lays out the government's plans for raising and lowering taxes.

The chancellor will also speak on government plans for public spending, including on schools, health and defence.

The statement tends to start with a review of the nation's finances and its economic situation, moving on to the proposals for taxation.

You can read more about the details in the budget here...

By Faye Brown , political reporter

Rishi Sunak has tonight suffered a number of sizeable defeats in the House of Lords over his controversial bill to rescue the stalled Rwanda plan.

Peers have voted through five amendments which, if enacted in law, would make it harder for parliament to declare the African nation 'safe' and would require the government to comply with domestic and international law.

This would effectively kill the central purpose of the legislation - which aims to prevent further legal challenges against the policy after it was ruled unlawful by the UK's Supreme Court .

The votes don't scupper the bill entirely, but set into motion the process of parliamentary "ping pong" between the Lords and the Commons until an agreement is reached.

As well as compelling judges to regard Rwanda as safe, Mr Sunak's Safety of Rwanda Bill is designed to give ministers the power to disregard key sections of the UK's Human Rights Act and other international rules that stand in the way of deportations.

Peers from across the political divide have criticised it because they believe it breaks international law.

Read more below:

One year ago, Rishi Sunak made five pledges for voters to judge him on.

The prime minister met his pledge to halve inflation by the end of 2023, leaving four pledges outstanding.

However, he is faring less well with his other pledges.

It has been confirmed the UK is now in recession, which means the PM's pledge to grow the economy is not being met.

With the general election approaching, how is Mr Sunak doing on delivering his other promises?

You can see the progress for yourself below.

Finally on Politics Hub With Sophy Ridge , we are looking at a news story that sounds like something out of a spy novel - Russia has intercepted a discussion among the German military about operations in Ukraine.

The Russians managed to access a chat which was hosted on the Webex conference platform - rather than a secure army platform.

In the 38-minute call, the German air force chief discussed possible supplies of Taurus missiles - a pretty serious breach, and embarrassing for the Germans.

But this is not the first time the powers that be were not so careful about very classified information.

Back in 2000, there was a furore when it was revealed an MI6 officer mislaid a laptop containing classified material after drinking at a tapas bar in central London.

A few years ago, more classified defence documents - which went missing - were discovered by a member of the public in a reportedly "soggy heap" behind a bus stop in Kent.

And just last year, official documents about a "hunter killer" Royal Navy submarine were reportedly discovered in the loos of a Wetherspoon in Cumbria.

Our panellists describe the German leak as "really serious" which will "seriously damage trust, particularly among the Five Eyes Allies in Germany".

And we ask a former Home Office adviser whether he ever accidentally left classified documents in a Wetherspoon pub.

Watch the full discussion here:

That concludes tonight's edition of Politics Hub With Sophy Ridge - scroll down for all the key moments and highlights.

Next on Politics Hub With Sophy Ridge , we are hearing from  Daniel Kebede , general secretary of the National Education Union, and we start by asking what he wants to hear from the chancellor at the budget.

He says Rishi Sunak and his team have previously asserted that eduction is a "silver bullet", but adds: "We haven't seen any evidence of them investing at all."

He has written to the government "multiple times" to ask for funding to fix school buildings, improve special needs eduction, and restore funding, but no investment has been forthcoming.

"We're really hoping for them to change course this week," he says.

Sophy puts to Mr Kebede that the government would say that they are prioritising education in a bad economic environment, and he replies: "Children wouldn't say that, nor would the parents or the teachers in schools currently."

He goes on: "We literally have schools crumbling around the heads of children due to this government's neglect of eduction."

He also cites "record class sizes" due to low teacher pay driving people out of the profession.

"The reality is, education at the moment is on the brink - we really do need to see some investment."

He says the public wants to see proper investment in public services, rather than large tax cuts.

Mr Kebede also calls on Labour to be "much more ambitious" than the plans they have currently announced, saying there needs to be a "plan of action" to restore education and tackle child poverty.

Next, we are speaking with our Politics Hub  panel about the Rochdale by-election and George Galloway being sworn in to parliament.

James Starkie , former Tory Home Office adviser, says the result will "change the debate" and Mr Galloway will "clearly capture the media attention on a regular basis", which both parties will have to deal with.

Whether his Workers' Party of Great Britain will actually impact the election more broadly is "hard to tell right now".

Sir Ben Bradshaw , Labour MP and former cabinet minister, rejects Mr Galloway's assertion that Labour was "crushed", and says the party "probably would have won" had they supported a candidate.

"The worry I have is that Galloway will add to the general toxicity of this debate," he says.

Sir Ben said he "could not understand" Rishi Sunak making a "ridiculous" speech on Friday criticising Mr Galloway's win, saying he likes nothing more than attention.

"If you watch how Labour MPs and Sir Keir Starmer react to him, I think they will do their upmost to ignore him because he craves attention - that's what he lived off."

He adds: "The best tactic is to completely ignore him... for the good of our country and for the good of one's own sanity."

The House of Lords has been busy tonight, delivering a bit of ruthless battering to the government's Rwanda plan.

What have they been up to?

Peers there have been voting on amendments to legislation that would see the country deemed a safe place to send asylum seekers, which the prime minister has been trying to get passed to bypass a Supreme Court ruling from last year that deemed it unsafe.

Only once Rwanda has been ruled safe can the government hope to start sending migrants there.

MPs are set to back it when it comes back to the Commons, but in the meantime the Lords gets a say.

What have they done?

These amendments are designed to make the bill more palatable to disapproving peers - perhaps the most undermining of them from the government's perspective would be to ensure the bill maintains "full compliance with domestic and international law".

That would effectively kill the core purpose of the bill, which seeks to sideline the influence of the courts.

With all five amendments presented tonight having been backed by the House of Lords, it's the worst series of defeats peers have inflicted upon Rishi Sunak since he became prime minister.

What does it all mean?

Our chief political correspondent Jon Craig says what's really significant tonight is the "scale of these defeats", with Tories including former members of John Major's cabinet having voted against the government.

The first three votes were all backed by majorities of more than 100, with the other two well above 80.

More amendments will be voted on this Wednesday, before the bill goes back before MPs on 18 March.

The government still hopes to pass the bill by Easter and then get flights off the ground, with the Lords' opposition largely symbolic.

Mr Sunak still won't be happy, though - you may remember he urged peers not to vote against the bill earlier this year, declaring it to be the will of the people.

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  12. Models of leadership and their implications for nursing practice

    Abstract. Leadership in today's NHS, either as a leader or follower, is everybody's business. In this article, an MSc student undertaking the Developing Professional Leadership module at King's College London describes two leadership models and considers their application to two dimensions of the NHS Healthcare Leadership Model: 'Engaging the team' and 'Leading with care'.

  13. Leadership in Nursing

    A clinical nursing leader is one who is involved in direct patient care and who continuously improves the care that is afforded to such persons by influencing the treatment provision delivered by others (Cook, 2001). Leadership is not merely a series of skills or tasks; rather, it is an attitude that informs behaviour (Cook, 2001).

  14. Importance of Leadership Style towards Quality of Care Measures in

    Papers published from 2004 to 2015 (focus on more recent knowledge) Human epidemiological studies. ... Most importantly, engagement of non-medical clinical leaders, such as nursing leadership, is considered to ensure the legitimacy and validity of priority setting . As shown in the present study, the leadership styles that proved to be more ...

  15. What is Nurse Leadership?

    Nurse leadership is the ability to inspire, influence and motivate health care professionals as they work together to achieve their goals, according to Mandy T. Bell, DNP, MSN, RN, clinical faculty of graduate nursing at SNHU. Dr. Marie Morganelli. Jul 13, 2021.

  16. The Importance of Leadership in Nursing

    Conclusion. The importance of effective leadership to the provision of good quality care is firmly established, as is the central role that leadership plays in nursing (Cummings, 2008). It is now also clear that leadership should be found at all levels from board to ward and it seems obvious that the development of leadership skills for nurses ...

  17. Leadership in Nursing Skills

    Leadership in Nursing Skills. Leadership is process of persuading others to work toward achieving the common desired outcomes (Whitehead, Weiss and Tappen, 2007). In healthcare settings, leadership and quality of care are interlinked. Nursing leadership plays vital role in organisational success as it is client oriented.

  18. Inspiring Leadership in Nursing: Key Topics to Empower the Next

    Nursing leadership is a critical component of the healthcare industry, impacting patient care, organizational performance, and the advancement of the nursing profession. By mastering essential leadership skills, embracing diversity, promoting teamwork, and fostering a positive work environment, aspiring nurse leaders can make a meaningful ...

  19. Impacts Of Leadership On Nurses Nursing Essay

    This essay will analyses leadership and how it impacts on organisational culture and the effects on nursing staff, this paper will show the difference between leadership and management, consider the impact and influence of organisational culture on patients and their outcomes, this essay will explore the theories of leadership and show the elements required to have an effective sustainable ...

  20. A caring leadership model in nursing: A grounded theory approach

    Grounded theory was used to develop the theoretical model of caring leadership. Both semi‐structured interviews and open‐ended questionnaire surveys were used to collect data for constructing the theory model. Ten nurse leaders and 11 nurse staff were recruited for an interview, and 168 nurse leaders and 286 nurses were recruited for an ...

  21. Nursing Leadership and Personal Skills Personal Essay

    Finally, personal qualities determine the nurses' ability to lead. My personal skills have a significant impact on my leadership skills. I am very persistent, determined and communicative. My persistent nature has enabled me to stay focused on achieving my goals. My determination has kept me going even when faced with challenges.

  22. Leadership And Management In Nursing Nursing Essay

    Leadership And Management In Nursing Nursing Essay. Mergers illustrate the focus on organisational restructuring as the key lever for change as indicated by the ninety nine health care provider mergers in England between 1996 and 2001. (Fulop, Protsopsaltis, King, Allen, Hutchings, and Normand, 2004) However, in many cases, mergers have ...

  23. Transforming Leadership

    In addition to changes in nursing practice and education, discussed in Chapters 3 and 4, respectively, strong leadership will be required to realize the vision of a transformed health care system. Although the public is not used to viewing nurses as leaders, and not all nurses begin their career with thoughts of becoming a leader, all nurses must be leaders in the design, implementation, and ...

  24. Politics latest: Speculation mounts over pre-election budget; Labour to

    The pre-election budget will be delivered on Wednesday, with the Conservatives hoping to shift the dial as they languish in the polls. Listen to this week's Politics at Jack and Sam's podcast as ...