Nurse Keith: Nursing Leaders for the 21st Century

Nurse Keith: Nursing Leaders for the 21st Century

The healthcare and nursing landscapes have radically changed over the last several decades. Nurse leaders are now face to face with 21st-century realities that Florence Nightingale could never have predicted. It’s a wild world out there, and prudent nurse leaders are prepared for anything. 

The politics of healthcare

At the time of this writing, the Affordable Care Act (popularly known as “Obamacare”) is still with us, and it appears that rumors of its demise may have been premature (to paraphrase Mark Twain).

In times of political uncertainty, healthcare’s presence on the legislative chopping block can cause patients and providers to feel nervous about the future. Uncertain times breed anxiety, and nurses can feel as anxious as anyone else about what will happen or not happen down the road.

Savvy nurse leaders do their best to read the writing on the wall and stay informed about the issues of the day that may impact staff, research, patient care and outcomes, education, or health insurance. The nurse leader obviously can’t know it all, but information is powerful, and having reliable resources is helpful.

When the sands are constantly shifting, being able to educate both staff and patients can help to address some fears while recognizing that much is outside of our control.

Technology and nursing

There’s no denying that technology and healthcare are now inextricably joined at the hip, and nurse leaders need to understand the implications. The nursing workforce needs training to be more than proficient in the use of new technologies, and nurse leaders can champion the education of those nurses.

Meanwhile, patient technology is changing as well, and patients need guidance in the use of wearable technologies, home-based monitoring, and other breakthroughs. While the nurse leader may not directly teach patients, the nurses who report to that leader should be adequately trained to address patients’ questions and knowledge deficits.

An MSN in nursing informatics can be highly useful to nurses who want to remain on the cutting edge, and the cutting edge is where smart nurse leaders want to be.

Cultural changes and healthcare

In the 21st century, healthcare is increasingly diverse. Even as those in power debate immigration, nurses on the front lines are more concerned with treating patients’ symptoms and returning them to optimal health.

In both cities and rural areas, nurses come into contact with patients from a variety of backgrounds, ethnicities, and religions; these go hand in hand with widely varying cultural practices and beliefs.

In terms of diversity, new ways of expressing gender, sexuality, and the nature of relationships and family are also impacting the delivery of healthcare. The changes will continue, and staying culturally current is paramount.

Nurse leaders for the future

A thoughtful nurse leader takes into account the political, economic, social, technological, and cultural changes that are having an affect on staff, patients, and organizations.

The delivery of care doesn’t stop in its tracks so that we can pause to consider the implications of a patient’s immigration or economic status. We can’t close down a hospital as we attempt to draft a policy on equitable and sensitive LGBTQ and transgender healthcare. The nurse leader needs to learn and react on the fly, leading by example, and shining a light in areas that others find dark or confusing.

Twenty-first century nurse leadership is about being awake, aware, and alive to the cultural moment, and leading from a place of inspiration. Are you an inspired nurse leader who will carry the profession forward?

Keith Carlson, RN, BSN, NC-BC is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, speaker, consultant, author, and popular career columnist. With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s two podcasts, RNFM Radio and The Nurse Keith Show, offer inspiration and practical support to nurses seeking to create meaningful, satisfying lives and careers. Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. He can be found at

Empower yourself with knowledge through an online RN to BSN or RN to MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in case managementinfection control, and executive leadership.


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