LEADERSHIP IN GRADUATE PRACTICE Essay Example

  • Category:
    Nursing
  • Document type:
    Essay
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    1986

9Clinical Nurse Leadership

Institute:

Introduction

Clinical Nurse Leader (CNL) is a new nursing role developed to address both quality and safety concerns of the health care organizations and providers. This role was developed in response to the global issues of quality and safety of the nursing care within the complex, ever-changing and technologically advanced health care systems. Whether as a clinical nursing graduate leader or advanced nurse generalist, the CNL should be educationally prepared so as to enhance the patient care outcomes by the use of a micro-system assessment process as well as managing the care delivery of various patients. As a clinician, the CNL is expected to make use of the evidence-based information in order to design and coordinate the health care delivered to people and cohorts of patients in both the rural and urban hospital micro-system (Batalden et al., 2007).

It is perceived that through some lateral integration of the health care, the CNL has the ability to facilitate and organize multiple disciplines as well as health services. This is aimed at ensuring the most efficient and more goal-directed activities are well performed and at the right time. Therefore, reduced fragmentation of the health care and gaps within the communication links contributes more to cost-effective, high patient satisfaction and improved clinical outcomes. This implies that as a graduate-level advanced in nursing knowledge of various illness and disease management, innovative nursing interventions as well as health assessment. The CNL demonstrates the nursing leadership that is needed at the point of health care so as to ensure high quality and the safe universal nursing care (Begun, Tornabeni & White, 2006).

Implementing the new health care-delivery models, redesigning of the nursing work environments as well as strengthening the clinical nursing leadership are the major components of retaining nurses, enhancing patient outcomes, and in delivering high quality patient care. This implies that clinical nursing leadership skills are vital in resolving the issues which cause practice redesign. In addition, these skills are significant in bringing about the aspects required of effective Professional Practice Models (PPMs).

Therefore, support of the clinical nurses, their professional and leadership development abilities from the hospital leaders is considerably a key attribute of the clinical nurse satisfaction and achievement of the PPMs in hospitals The CNL is a leader within the health care delivery system through which all the settings in of health care is delivered and not simply an acute care setting. However, implementation of the CNL role varies across such settings its role is not considered to be one of the administration or management. This leader is unique because he or she functions within a micro-system, and thus assumes accountability for the healthcare outcomes for a particular group of clients in a unit (Nelson et al., 2008).

The setting may be through the assimilation or application of the research-based information in order to design, implement as well as evaluate the client’s plans of care. This defines the CNL as a provider and manager of the health care at the point of delivery to individuals and cohorts. Dealing with the health care needs of the people, the CNL designs, implements and carefully evaluates the client care by organizing, delegating as well as supervising the care which is provided through a health care team such as licensed nurses, technicians, and some other health professionals (Bowcutt & Goolsby, 2006).

Assessment, critical thinking, mastery of nursing technology, communication and resource management are the core competencies of the clinical nurse leadership. The CNL demonstrates such competencies while carrying out his or her roles as a clinician, outcomes manager, client promoter, information manager, risk anticipator, educator, team manager, and as a member of the health care profession. It becomes apparent that the leadership roles of a CNL correlate to the desired behaviors within the PPM (Smith et al., 2006).

Furthermore, both the competencies and roles are provided to enable the program participants develop their current leadership skills as well as improve on their patient-care delivery. This suggests that participants in the professional practice models, such as the new graduate nurse in the clinical practice are expected to utilize their CNL leadership characteristics by integrating them in their day after day practice so as to attain the desired outcomes of PPM. It is true that participants engage in various action learning activities in order to integrate the specific components of the professional practice models and the key notions of clinical nursing leadership in their practice (Gabuat et al., 2008).

Instances of CNL effectiveness which are focused on enhancing clinical outcomes involve improved rates of home health care referrals and core measure data, discharging planning, reduced nursing staff turnover and the length of stay, high patient satisfaction, reduced fall rates, and less cardiac arrest. This implies that satisfaction outcomes not only involve patient satisfaction, but also nursing the staff satisfaction which is clearly reflected by high retention rates, rendering more power to the nursing staff, and participating in the career advancement opportunities (Rusch & Bakewell-Sachs, 2007).

Therefore, fostering of the clinical nursing leadership as well as professional practice is central to creating more healthy work environments, enhancing patient outcomes, and supporting desired organizational outcomes. It is apparent that strong leadership skills and the associated professional nursing behaviors, for instance, planning, team leading, decision-making, resource management and accountability for the patient care outcomes are some of the valuable tools for clinical nurses to provide the professional care that may be demanded by patients (Disch, Walton & Barnsteiner, 2007).

Most of the preparations made on the CNL include unrelenting demands for evidence-based aspect of the health care practices.
Although a significant number of the higher education programs in nursing have shifted from ritualistic and process-based teaching to evidence-based, outcome orientation. As a result, many graduates have discovered the importance of routine reading of their professional journals as well as incorporate the new evidence into practice.
This implies that Clinical Nurse Leadership activities require proficiency in knowledge acquisition, management of change, working in groups and dissemination of the newly acquired knowledge to other professionals in the health care field
(AACN, 2007).

In my attempt to justify clinical actions based on evidence, I will apply evidence that challenges the current policies and procedures in my practice environment. Thus, incorporate the acquired evidences into various practice situations that will include the education of other team members in the health care field.
As the interdisciplinary care team practitioner, I will delegate and manage the nursing team resources such as fellow staff and supplies. Through my careful understanding of the human interactions, application of problem-solving skills, communication, conflict management, and team building, I will be able to advance my patient-care delivery through an effective team work. As an educator with fresh graduate skills and knowledge, my plans will be to prepare individuals, cohorts of clients or families for self-care as well as a maximal level of performance and wellness (AACN, 2007).

In order to maximize patient wellness, health promotion, and take risk reduction measures, I will consider education programs which are designed and implemented with more emphasis on those patients with chronic illnesses. In working at the point of health care in the micro-system I expect to be in a position to mentor any new member of the clinical nursing staff, fostering evidence-based practice, critical thinking as well as undertake sound clinical decision-making (Tachibana & Nelson-Peterson, 2007).

As a member of the health care profession, it means that I will be personally accountable for my own personal practice. Therefore, I will actively engage in the acquisition of skills and knowledge to effect positive changes within the health care practices, outcomes and in the entire clinical health care profession. This implies that being a lifelong learner, I have to recognize the need for me to actively pursue the new knowledge and skills as the practice roles as well as the health care systems evolve (AACN, 2007).

Since my task of clinical nurse health care requires me to be outcomes manager, I will involve in thorough preparation to lead quality enhancement initiatives. This means that I will be tasked to design research-based interventions which can reduce error, improve patient safety and stream-line the processes of healthcare delivery. As a practitioner in health care I will evaluate patient health and the nursing care process outcomes. This will be achieved through my careful analysis of various data, communicate the findings to assigned healthcare team and participate in team implementation of the initiatives to treat deficiencies in the micro-system. As a result, I will ensure the organizational effectiveness of the CNL that is measured through improved clinical, financial, and health care satisfaction outcomes (Hix, McKeon & Walters, 2009).

The role and effectiveness of the CNL has to larger extent been examined from the perception of various urban health care settings. Therefore, research to further examine the healthcare outcomes of the Clinical Nurse Leader’s role within the diverse rural health care settings need to be considered. It is a call for the CNLs to be educationally trained to participate in the research process as well as in the advancement of innovative nursing interventions which are specific to the rural nursing practice (Harris, Tornabeni, & Walters, 2006).

Conclusion

Whether as a clinical nursing graduate leader or advanced nurse generalist, the CNL should be educationally prepared so as to enhance the patient care outcomes by the use of a micro-system assessment process as well as managing the care delivery of various patients. Reduced fragmentation of the health care and gaps within the communication links contributes more to cost-effective, high patient satisfaction and improved clinical outcomes. Fostering of the clinical nursing leadership and professional practice is central to creating more healthy work environments, enhancing patient outcomes, and supporting desired organizational outcomes.

Assessment, critical thinking, mastery of nursing technology, communication and resource management are the core competencies of the clinical nurse leadership. Most of the leadership roles of a CNL correlate to the desired behaviors within the Professional Practice Models (PPMs). As a result, both the competencies and roles are provided to enable the program participants develop their current leadership skills as well as improve on their patient-care delivery.

References

American Association of Colleges of Nursing (2007). White paper on the education and role of the Clinical Nurse Leader. Retrieved August 13, 2011 from, <http://www.aacn.nche.edu/publications/whitepapers/ClinicalNurseLeader07.pdf>

Begun, J.W., Tornabeni, J., & White, K.R. (2006). Opportunities for improving patient care through lateral integration: The clinical nurse leader. Journal of Healthcare Management. 51(1), 19-25.

Batalden, P.B, et al., (2007). Microsystems in Health care. Part 9. Developing Small Clinical Units to attain Peak Performance. Joint Commission Journal on Quality and Safety. 29(11), 575-585.

Bowcutt, M., Wall, J., & Goolsby, M.J. (2006). The clinical nurse leader: promoting patient-centered outcomes. Nursing Administration Quarterly. 30(2), 156-161.

Disch, J., Walton, M., & Barnsteiner, J. (2007). The role of the clinical nurse specialist in creating a healthy work environment. AACN Clinical Issues.12(3), 345-355.

Gabuat, J., Hilton, N., Kinnaird, L.S., & Sherman, R.O. (2008). Implementing the clinical nurse leader role in a for-profit environment: A case study. Journal of Nursing Administration. 38(6), 302-307.

Harris, J.L., Tornabeni, J., & Walters, S.E. (2006). The clinical nurse leader: a valued member of the healthcare team. Journal of Nursing Administration. 36(10), 446-449.

Hix, C., McKeon, L., & Walters, S. (2009). Clinical nurse leader impact on clinical microsystems outcomes. Journal of Nursing Administration. 39(2), 71-76.

Nelson, E.C., et al. (2008). Clinical microsystems, part 1. The building blocks of health systems. Joint Commission Journal of Quality and Patient Safety. 34(7), 367-378.

Rusch, L., & Bakewell-Sachs, S. (2007). The CNL: A gateway to better care? Nursing Management. 38(4), 32-37.

Smith, S. L., Manfredi, T., Hagos, O., Drummond-Huth, B., & Moore, P.D. (2006). Application of the clinical nurse leader role in an acute care delivery model. Journal of Nursing Administration. 36(1), 29-33.

Tachibana, C., & Nelson-Peterson, D.L. (2007). Implementing the clinical nurse leader role using the Virginia Mason Production System. Journal of Nursing Administration. 37(11), 477-479.