Running head: NURSING LEADERSHIP ROLES

Nursing Leadership Roles Scott Kowalewsky Ferris State University

NURSING LEADERSHIP ROLES Abstract The purpose of this paper is to identify the two roles needed to be carried out by nurses for a community project to get people to eat healthier foods. Moreover, this paper is going to discuss important characteristics that a leader and care giver should possess to be effective in helping

implement change to people in their eating habits. Then, I am going to provide evidence on how the roles of a nurse leader and direct caregiver are similar, and how they are different. Also, the impact that nurses can have on political representatives and laws and regulations is going to be conversed. After analyzing the two different roles, I am going to provide a reflection on my current skills in relations to the roles, the challenges I will face, and what I can do to improve my competence.

NURSING LEADERSHIP ROLES Nursing Leadership Roles A nursing role that will be needed in the project to increase healthier eating will require nurses to work directly with teens and families to implement healthy changes. They will assess

habits, identify bad habits, and offer solutions to change those habits. Another role required of a nurse will be to manage and oversee the other nurses. The two different roles require some of the same roles, and they also each require different roles. My personal leadership qualities (energetic, hardworking, committed, determined, and knowledgeable) will fit both the managing and direct care roles. Almost every role in nursing requires hard work and determination. In order to teach new healthy habits to teens, a leader has to be resourceful and have knowledge on the subject. I have taken several nutrition classes in college gaining knowledge on what healthy foods are and what foods are unhealthy. Lastly, my energy and commitment will be needed to successfully convert teens from unhealthy habits, to healthy ones. (Sammer & James, 2011) Roles Both of the roles, nurse leader and the direct care nurses need to be safe in practice, and promote a safe environment. It is important that nursing leaders adequately assess the safety culture in their workplace and clearly articulate a framework to guide personnel as they work to increase safety within their work settings (Sammer & James, 2011). Furthermore, the need to have a safe culture surrounding the program and positive attitudes is important, so it will be inviting for people to join and benefit from. People go where they feel comfortable, making healthy eating a positive image is important to make it a success. A culture of safety is more than just free from errors, a culture of safety includes the attitudes and behaviors that are related

NURSING LEADERSHIP ROLES to patient safety and that are expected and appropriate to promote patient safety (Sammer & James, 2011). To create a safe culture, it will require both the nurses providing care and managing. It will not happen on its own and will require effort from everyone. How does one go about making a safe culture in their organization? The important factors for implementing a safe culture in nursing are to have commitment to the following characteristics. These characteristics include: (a) leadership, (b) evidence-based practice, (c) teamwork, (d) communication, (e) a learning culture, (f) a just culture, and (g) a patient-centered culture (Sammer & James, 2011). The role of a nurse leader for helping people eat healthier requires moral courage. The characteristics of moral courage for a nurse leader are to be competent, visible, credible and an expert. Furthermore, it is important for leaders to help avoid moral regret with their workers. Nurse leaders who intentionally provide for and invite open discussion of decisions from a moral perspective and who avoid last minute, rushed, and unplanned decisions have the greatest opportunity to assist others in avoiding moral regret (Edmonson, 2010). Another way for leaders to avoid moral distress is to follow the 4 As framework from the American Association of Critical-Care Nurses. The 4 As include ask, affirm, assess, and act. Ask allows a leader to

investigate what happened and to become aware of issues as they present themselves. Affirming with employees after identifying what happened is important to address the source of problem. Then, a leader can use their critical assessment skills and reasoning to assess the situation. Lastly, is the leader acting on the situation (Edmonson, 2010).

NURSING LEADERSHIP ROLES According to the American Nurses Association Code of Ethics, it calls for nurses to act when patients, their peers, or their own rights have been violated. Nurse leaders and direct care nurses both feel distress from violations. On the other hand, nurse leaders are prone to more distress from violations because of their added responsibilities to themselves, and to the

company. Furthermore, nurse leaders are expected to establish an ethical culture for their nurses in practice (Edmonson, 2010). This correlates with the ANA standards of practice and expectation at our organization. The nurse in all professional relationships practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems (The American Nurses Association, 2010). Analysis The nurse leader and the direct care nurse have similar roles. They both work towards the same goal, improving patient outcomes. The clinical nurse leader is accountable for the care outcomes of clinical populations or a specified group of clients in a healthcare system. As clinical decision-maker and care manager, the CNL coordinates the direct care activities of other nursing staff and health professionals (American Association of Colleges of Nursing, 2007). Other similarities in their roles are to keep current with new technologies and research to improve healthcare. Change is constant, healthcare is changing and the role and practice of the professional nurse is changing along with it (Tomajam, 2012). Moreover, they both have the ability to make a positive impact on the profession and lives of patients. Every nurse in every setting has the opportunity to make a positive impact on the profession through advocating daily for nurses and the nursing profession (Tomajam, 2012). Lastly, they both can delegate to other healthcare professionals, they not only delegate clinical actions for meeting the needs of the

NURSING LEADERSHIP ROLES client but also an organizational plan for delegation of care to assisting personnel, including the teaching and evaluation activities that would need to accompany such delegation. (American Association of Colleges of Nursing, 2007). Direct care nurses and nurse managers/leaders have some different roles. Nurse Managers and leaders have the responsibility of ensuring there is appropriate staff and

environment. Managers and administrators work daily, advocating to obtain adequate resources for their nursing staff and to promote positive work environments (Tomajam, 2012). Furthermore, direct care providing nurses do not have the responsibility of the working in all of the systems in a healthcare facility; they focus more on physical patient care and do not supervise. The nurse leader designs, implements, and evaluates client care by coordinating, delegating and supervising the care provided by the health care team, including licensed nurses, technicians, and other health professionals (American Association of Colleges of Nursing, 2007). The roles of both nurses that I have discussed above can play a direct role in politics. When nurses identify areas of healthcare that could be improved, they can get involved with government officials to try and make new laws. Nurses have a unique opportunity fulfill their social responsibility as health promoters by collaborating with political and healthcare leaders to created sustainable solutions to identified needs (Crawford, 2012). In relation to Healthy Habits for Teens, a nurse could work with a government representative to make a law that would improve school lunch programs to be healthier for children. The suggestions for the different skills needed by a nurse for the topic of healthier eating are as follows. Firstly, nurses should be trained skills that will help them provide nutritional

NURSING LEADERSHIP ROLES care. Nursing staff needs access to skills training that ensures that they can contribute to nutritional care through their understanding of the tools, techniques and current best practices (Royal College of Nursing, 2013). A skill that a nurse should possess is being able to

nutritionally screen an individual. Also, a nurse should have the skills to assess people and make care plans. If a nurse possesses these 3 skills, they should then be able to get people to identify risks and benefits, the importance of nutrition, nutritional planning, and the causes and consequences from unhealthy eating (Royal College of Nursing, 2013). Reflection My skills that are most suited for the patient care role are hardworking and committed. It will not be easy to assess people and teach them how change their habits. It will require someone to work long hours, through adversity, and be resilient (hardworking). Furthermore, I think a person would have to be committed to help people eat healthier. If one did not have interest in doing it, they will most likely not be successful. To fulfill the leader role, my skill that would be most important is my knowledge on nutrition, my knowledge in nursing, my past experiences, and my determination. To be a good leader, one would have to be resourceful and have previous experience in leading it. Lastly, the leader would have to be determined to make the program work; otherwise the program may not succeed. The role requirements that would be a challenge for me as the leader are evaluating staff and supervising them. I would give my best effort to do the best supervising and evaluating that I could, but I have limited experience in those areas. I supervise my nurse aids at work, that is one person, supervising an entire program would be a struggle. The other role I think I would

NURSING LEADERSHIP ROLES struggle at would be evaluating, I always set expectations for myself really high. I fear that I would be too critical and hard in evaluating people. To be a competent leader, I could attend seminars to learn what other leaders are doing and exchange ideas with them. Also, I could subscribe to journals and seek a masters degree to

become a more competent leader. Furthermore, I could wait to become a leader or manager after I get more experience as a nurse, further building my skills and experience. To become a competent direct care giver to people, I can challenge myself to learn as much as I can with future opportunities. Lastly, I could ask a nurse educator for help to improve on areas that I struggle with.

NURSING LEADERSHIP ROLES References American Association of Colleges of Nursing. (2007).White paper on the role of the clinical nurse leader. Retrieved from http://www.aacn.nche.edu/publications/white-papers/cnl Crawford, B. (2012). Global health. Retrieved from http://www.northwestcollege.edu/dotAsset/159401.pdf Edmonson, C. (2010). Moral courage and the nurse leader.The Online Journal of Issues in Nursing, 15(3), doi: 10.3912/OJIN.Vol15No03Man05 Royal College of Nursing. (2013). Nutrition - knowledge and skills. Retrieved from http://www.rcn.org.uk/development/practice/nutrition/knowledge_and_skills Sammer, C., & James, B. (2011). Patient safety culture: The nursing unit leaders role. The Online Journal of Issues in Nursing, 6(3), doi: 10.3912/OJIN.Vol16No03Man03 The American Nurses Association. (2010). Code of ethics for nurses with interpretive statements. Retrieved from

http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/C ode-of-Ethics.pdf Tomajam, K. (2012). Advocating for nurses and nursing. The Online Journal of Issues in Nursing, 17(1), doi: 10.3912/OJIN.Vol17No01Man04