Running Head: Nursing Leadership Role

Nursings Leadership Role in Population Based Issues Andrea Mygrants Ferris State University

Running Head: Nursing Leadership Role Abstract Access to healthcare resources is an important issue that faces both our country and the profession of

nursing. As nurses we advocate for the health and well being of our patients. However, people without access to healthcare services often lack the tools necessary to achieve lasting health or wellness. According to Healthy People 2020, Access to health care impacts: overall physical, social, and mental health status; prevention of disease and disability; detection and treatment of health conditions; quality of life; preventable death; and life expectancy. (US Department of Health and Human Services, 2013) This paper will attempt to look at how nursing roles can both effect access to health care on an individual and/or family level, as well as a community and population level.

Running Head: Nursing Leadership Role According to Healthy People 2020, Access to health care services in the United States is regarded as unreliable; many people do not receive the appropriate and timely care they need (US Department of Health and Human Services, 2013) It is this problem that prompted our group to base our project on the problem of access to health care. There are many reasons why people have problems accessing healthcare. Some reasons given by the Healthy People 2020 initiative are, lack of available providers, high cost, and inability to obtain health insurance. (US Department of Health and Human Services, 2013) As nurses it is our job to advocate and work toward the health and wellness of our patients, and this includes helping our patients gain access to appropriate healthcare resources. This can be

accomplished by nurses who work with patients on both an individual or family level and a community or population level. Identifying Nursing Roles Nurses who work with patients on an individual or family level definitely have a role to play in helping patients gain access to healthcare. These are the nurses who see the specific challenges and needs of their patients and can help them develop a plan to overcome these challenges. This is in contrast to nurses who's work focuses on entire communities or defined populations. These nurses must look at the population as a whole to determine what problems exist in healthcare access and what resources are available to solve these problems. To achieve the goal of better healthcare access, each nurse must know and utilize their role in the healthcare system. Direct Contact Nurse A nurse in the direct care role could make an impact with access to health care in a variety of workplace settings. A hospital based nurse could become familiar with various programs and resources in the community, and then pass that information to patients and their families to use upon discharge. A home health nurse could also make recommendations about programs such as meals on wheels, respite care for families that are caring for loved ones, senior centers, and community centers. Nurses that

Running Head: Nursing Leadership Role work in clinics, offices, and schools can also be powerful informants to their patients and families on not only where to access healthcare, but also when, and how. In our proposal to increase access to healthcare, the direct care nurse can and should take a leadership role. Two leadership roles that are outlined in the American Nurses Associations (ANA) Standards of

Professional Nursing Practice that are important for direct care nurses in advancing access to healthcare are, Communicates effectively with the healthcare consumer and colleagues and Participates in efforts to influence healthcare policy involving healthcare consumers and the profession. (ANA, 2006) Both communicating available healthcare access opportunities to patients, and advocating on their behalf for policy that supports healthcare access for all people advances the overriding goal of increasing access to needed healthcare services. Community Leader/Manager Nurse A nurse in the role as a community leader or manager could seek opportunities to increase access to healthcare as a community health nurse, a nurse researcher who's research focuses on the cost savings and health benefits of nursing lead preventative care, and a nurse who works as a political policy advocate for increased healthcare access. A nurse in any of these roles would then concentrate their effort on the greater good of entire populations instead of individuals and families. Leadership roles that would be valued in this role of a community leader/manager nurse can also be found in the ANA's Standards of Professional Nursing, Participates in professional organizations, Communicates effectively with the healthcare consumer and colleagues, Seeks ways to advance nursing autonomy and accountability, and Participates in efforts to influence healthcare policy involving healthcare consumers and the profession. (ANA, 2006) Analysis Harkness and DeMarco explain community-oriented nursing as, ... providing healthcare to either individual people, families, and groups in the community, or to the community as a whole (Harkness

Running Head: Nursing Leadership Role & DeMarco, 2012) They then proceed to point out that community health nurses can be further differentiated by the scope they work within either with individuals and families, or with communities

and populations as a whole. Both nurses are similar in the fact that they both use the nursing process of assessment, diagnosis, planning, implementation, and evaluation. They would both draw from skills learned in nursing school that emphasize strong interpersonal, communication, assessment, and delegation skills. These roles would be different in that the direct care nurse would focus efforts at access to healthcare to the individuals and families being taken care of, and the community leader/manager nurse would focus efforts on obtaining and using resources to improve the community or population as a whole. As mentioned above the ANA believes that nurses should display leadership by becoming involved in policy and political decisions regarding healthcare and nursing. Both the direct care nurse and the community leader/manager nurse share this role. This can be accomplished to further advance access to healthcare by participating in professional nursing organizations such as the ANA that lobby to encourage better healthcare access, voting on important legislation, writing letters to congressmen and senators to encourage them to vote for healthcare legislation, and participating in public events and rallies that bring public attention to the need for increased healthcare access to all citizens. Reflection In reflecting about both of these nursing roles, I believe that my personal skill set and interest lies within direct care nursing. I became a nurse because I enjoy interacting with patients and their families. I enjoy helping them to better themselves, their health, and educate them on how to take care of themselves and their families to achieve better health outcomes. While I am often frustrated by the difficulties that many of my patients have in receiving follow up care with primary care physicians, specialists, testing, and therapy, I do find satisfaction in helping them to better understand the resources available in the community and how to use them.

Running Head: Nursing Leadership Role

I do not believe that my current skill set and interest as a nurse would make me a successful community leader/manager nurse. While I can see the importance of their role in nursing, and appreciate the work that they do, I also imagine that they posses talents that I do not possess. A community leader/manager nurse would have to be good at lobbying politically, and fighting for funding and resources. I do not see myself as being very good, or even much interested in either of these skills. To cultivate my skills as a direct care nurse, I will continue to work on my BSN, continue to read journal articles, and continue to stay up to date with my certifications and continuing education. To assist my patients with access to healthcare I will continue to learn about resources available in the community that I work, and advocate that my patients and their families become informed consumers of available health care access resources. If I were to cultivate skills to become a community leader/manager nurse I would have to learn more about how to be successful in politics and community resource allocation. I would also have to become more competent in public policy, how to put together educational materials for communities, and how to use epidemiological data better. Overall, I believe that all nurses regardless of the target population that they work with need to advocate for better, more consistent access to healthcare for all citizens. Once fully implemented, the Affordable Care Act will assist more people to obtain insurance, but that is only one piece of the puzzle. With more people in the healthcare system we will also need to address the issues of location of healthcare services, transportation issues to receive healthcare, language and cultural barriers, and the shortage of providers of healthcare. I believe that nurses in both roles can and should play an influential role in alleviating all of these problems. By developing the nursing as an independent and professional role in healthcare, we are then able to step in and provide cost effective, wellness oriented to care.

Running Head: Nursing Leadership Role References

American Nurses Association.(ANA) (2010). Nursing scope and standards of practice. (2nd ed., p. 55). Silver Spring, MD: American Nurses Association. Harkness, G., & DeMarco, R. (2012). Community and public health nursing. (p. 188). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. US Department of Health and Human Services. (2013, April 13). Healthy people 2020: Access to health services. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1