Nurses are well educated in clinical skills and in the principles of nursing practice. Yet during their education, nurses often receive no training in leadership skills (in contrast, leadership principles are routinely taught in business schools and other types of vocational programs). Even so, many nurses leave the bedside and rise to positions at the management or executive level. How do they do it? This series will explore some of the secrets of effective nurse leaders.
Surveys show that far too many nurses feel powerless in their jobs: their perception is that they are unable to act autonomously or even have a voice in the policies that affect them. Some of it is rooted in the historical view of nursing as “women’s work” within a patriarchal medical hierarchy. But recent standards of nursing education are a contributing factor as well – nurses often receive no training in leadership skills, which are known to foster self-confidence.
The problem with powerlessness within the nursing profession is clear: it creates job dissatisfaction, stress, and burnout. It can lead to ineffective nursing management that compromises patient safety. And it’s incompatible with today’s increasing emphasis on multi-disciplinary care, where collaboration is key. In theory, nurses who have advanced to management positions have acquired, either through education or experience, a sense of personal empowerment. Yet, research suggests we might still have a long way to go. A 2011 study found that nurses in middle management in an acute care hospital setting did not feel fully empowered. A more recent study, published in 2014 in the Journal of Nursing Administration, found only moderate levels of empowerment among 140 clinical nurse managers at one large healthcare system in the northeast.
Clearly, we need nurse leaders who not only feel empowered themselves but have the skills to empower the nurses they supervise. Empowered nurses demonstrate autonomy and independent decision making skills. They can perform well without constant feedback. They feel like stakeholders in the whole care delivery system. Nurses are more likely to develop a sense of empowerment when they work at an organization that values structural empowerment – for example, by including nursing representatives in the process of creating policies. This gives nurses some influence in areas that have traditionally been governed by executive-level hospital administrators, and it is known to help promote the highest level of nursing excellence.
Empowered nurses are most likely to speak up about hospital policies and areas that need improvement. And there are compelling reasons why nurses should make their voices heard:
As frontline care providers, nurses have the most direct knowledge of the practices that drive patient satisfaction and well-being. They need to be able to articulate these insights to administrators that may lack such firsthand data.
Because healthcare resources are limited and because there is waste in the system, nurses must be good stewards of existing resources – including medical supplies, human resources, and capital equipment. Nurses can, and should, help shape evidence-based practice where resources are concerned – even when it’s as simple as suggesting simple procedural changes that can save time and steps.
The ANA’s Nursing Code of Ethics specifically states that nurses are responsible for continuously enhancing the quality and effectiveness of nursing practice. In other words, it is simply not ethical for nurses not to speak up with suggestions or concerns.
One of the most important traits of empowered leaders is that they are facilitators of change. They feel capable of identifying areas that need improvement and working to bring about transformation. Most healthcare organizations have compliance programs in place to deal with government-mandated change. Many also have some sort of process improvement plan that functions at the executive level, with goals of reducing costs, enhancing efficiency, and improving patient care. But how much input comes directly from nursing managers? Managers who have a clear vision of the future can develop a strategy around that vision to bring about change.
This ability to initiate and manage change is a skill that can be taught. In recognition of this, American Sentinel University has forged a commitment to empowering nurses through leadership-oriented education. The Capstone Project, an exercise in applied learning, is one example of this. It allows students to design and implement a project that closely integrates their current work experience with their coursework, under the guidance of an academic advisor. American Sentinel’s online MSN, management and organizational leadership specialization degree is designed for experienced nurse professional who seek to develop both management and leadership skills.
Read the other parts of this four-part series to learn the other secrets of effective nurse leaders!