The need to improve the delivery of healthcare’s fundamental goals of quality and patient care led to the development of clinical nursing leadership (CNL) program. Additionally, in developing the clinical nursing leadership program, the American Association of Colleges of Nursing was motivated by the desire to equip nurses with the necessary competencies that are crucial to success in the current and future healthcare system changes. Rigorous research and consultations that exposed incompetence and neglect of patients by medical professionals especially nurses justified the need to formulate the program. In their capacities, clinical nursing leaders undertake many roles that are designed to achieve the goals as highlighted above by the AACN. It’s worthy to note that the role played by clinical nurses is neither administrative nor management.
It goes without saying that clinical nursing leadership has become part of mainstream nursing with unmatched success. This discussion will therefore focus on a critical evaluation of the effectiveness of the CNL to prove or dispel any informational inconsistencies on the effectiveness of CLN. To achieve the above objective, emphasis will be laid on three critical elements. First, there will be a somewhat in-depth analysis on the definition and description of CNL. The analysis will also make an effort to distinguish albeit lightly on the differences between leadership and management. Secondly, the discussion will look at the effectiveness of CNL in enhancing staff and patient outcomes. Finally, there will be a discussion on the practical application of CNL skills especially by a new nursing graduate. This final element will especially look at the how, where and why a new graduate nurse will apply CNL skills during deployment. There will also be a logical conclusion that will sum up the main points of the paper in a short and clear concise way.
What Is Clinical Nursing Leadership?
Clinical nursing leadership (CNL) is program encompassing skills training and development among nurses with the sole purpose of imparting leadership qualities to help in the enhancement of quality of patient care. It also prepares nurses to meet the needs of a dynamic and challenging healthcare environment (Thompson, Patricia Lulham & Kevin, 2007, pp.429-431). It’s important to note that CNL is more leadership oriented than management or administrative. Through the CNL program, a nursing leader performs multiple leadership functions including overseeing lateral integration and direction of patient care in all situations. Additionally, he/she ensures that patients gain from evidence based innovations while collecting and evaluating relevant information patient information for direction in change of care plans if necessary.
The leadership function is differentiated from the managerial one in that the clinical nurse leader forms part of a diverse inter-professional team that helps in implementing patient care (Rousel, 2010, p. 9). In his/her capacity, the clinical nursing leader coordinates the communication, planning and implementation of patient care among other professionals such as pharmacists, social workers, nurse practitioners and physicians.
How Clinical Nursing Leadership Effectively Enhances Staff and Patient Outcomes
The effectiveness of CNL can only be evidenced through the implementation of highly integrated scope of practice. This scope of practice revolves around efficient evaluation of patient care, creating the conditions necessary for optimal team performance and implementing the use of evidence based practice in an effort to improve patient safety, health outcomes and organizational systems (Harris, Tornabeni & Walters, 2006, pp.446-459). Optimal team performance and use of team-based practice will ensure enhancement of staff and patient outcomes. The effectiveness of CNL can be looked at from many angles. However, the above two form the most basic of perspectives through which the effectiveness of CNL can be analyzed.
As a clinician the effectiveness of a CNL is achieved through the utilization of evidence based information to come up with and deliver optimal care to patients. Effectiveness is especially achieved through lateral integration of care from other disciplines and services that ensures patients receive the most efficient care possible in the healthcare setting. Additionally, patient satisfaction is increased thanks to CNL’s initiatives that reduce care and communication inconsistencies resulting in improved efficiency and patient outcomes (Begun, Tornabeni, & White, 2006, pp.19-25). Patient outcomes are enhanced also by the fact that clinical nursing leaders are in possession of advanced knowledge on illness and disease management that guarantees innovative approaches in nursing interventions to patients needs.
The above scenarios detail the ways through which CNL enhances patient outcomes. Their logical validity makes sense in so far as patient outcomes are concerned. Given the long period through which CNL has taken to develop, the effectiveness of the CNL approach to ensure patient satisfaction has proven to be consistent. Despite the success however, effectiveness has not in some cases been achieved to the levels touted above. In these cases, the effectiveness of CNL does not cohere with what we know in the wider world. In a nutshell, the limited extent to which CNL has been applied and the results especially in the US have been impressive
In terms of staff outcomes, CNL contributes to effectiveness through enhancement of the style of management and delegation of team resources (Jolene & Judith, 2008, pp. 608-613). CNL enables leaders to better understand human interactions and communication. Additionally, it enhances effectiveness through equipping clinical nursing leaders with skills in problem solving, conflict management and team building (Harris & Roussell, 2010, p. 85). The main point emphasized above about CNL and delivery of staff outcome is the importance of effective teamwork in the delivery of patient care.
In my opinion, the whole logic behind CNL leans more on the development of the program than focusing primarily on the patient. Its internal consistency gives emphasis to the development of the team whose benefits will in turn trickle down to the patients in form of improved care. This idea therefore is very coherent with what is needed in the healthcare system not only in the US but worldwide.
How, Where and Why A new Graduate Nurse May Apply Clinical Nursing Leadership
As new graduate nurse, my skills as a clinical nursing leader will be in great demand. Different ideas come to the fore when considering when, how and why I can use my skills to help enhance patient care. Where: Precisely, I think my skills will be needed more in the rural areas. How: As a clinical nursing leader in the rural areas, I will take the role of an educator. Why: it’s common knowledge that the rural areas are more often than not marginalized in national development in many countries even in the developed world. People lag behind information or education of any kind including healthcare. That is why I think my skills are needed there.
According to Jukkala et al. (pp. 38-40), people in the rural areas are more exposed to illnesses compared to people in urban areas owing to a combination of demographic, geographic and socio-economic factors that breed adverse effects. Most of these people lack the very basic health information and rely heavily on the rural hospitals for primary care (Lutfiyya, Sikka, Mehta, & Lipsky, 2009, pp.112-118). The hospitals are themselves overwhelmed through staff shortage, limited technology and inadequate funding (Baldwin, et al., 2004; Casey & Moscovice, 2004, pp.99-108). According to (Casey & Moscovice, 2004, pp.327-334), there is a need to harness resources in terms of organizational staff through a collaboration with rural hospitals leadership to impart clinical knowledge on these populations.
It’s for this reason that I will choose to work in the rural areas in order to realize the universal goals of effective patient care in the healthcare system.
In my role as a CNL educator, I will be involved with preparing and enlightening the rural folk on the best ways of self and family patient care that may not be available in the hospitals. I will especially emphasize on educating people with chronic illnesses that sometimes require patients to stay at home with occasional visits to the health facilities. Additionally, I will aim at educating the staff of the rural health facilities through mentoring them on practicing and promoting evidence based practice that will help in delivering desirable patient outcomes.
In the article, I have focused on the meaning and the role of clinical nursing leaders. From the introduction, there is consensus among healthcare professionals that CNL is necessary and critical to the delivery of better patient care. An effort is made to clearly state that CNL is quite different from management as evidenced through the roles professionals from both fields play.
Section three of the article gives highlights on the effectiveness and ways through which CNL has contributed to the enhancement of patient care delivery and healthcare staff development. In that section I give a critical opinion on the logical validity, coherency with the current situation, consistency, applicability and results achieved as far as patient and staff outcomes are concerned.
In the last section, I adopt a more personal approach on the application of CNL. In the section I give explanations on the where, how and why I will apply my can skills upon graduation.
Baldwin, L.M., MacLehose, R.F., Hart, L.G., Beaver, S.K., Every, N., & Chan, L. (2004). Quality of care for acute myocardial infarction in rural and urban US hospitals. Journal of Rural Health, 20(2), 99-108.
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.
Casey, M.M., & Moscovice, I. (2004). Quality improvement strategies and best practices in critical access hospitals. Journal of Rural Health, 20(4), 327-334.
Harris, J.R., & Roussell, L. (Eds.). (2010). Initiating and sustaining the Clinical Nurse Leader role: A practical guide. Boston: Jones and Bartlett.
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), 446-44.
Jolene, T. F and Judith Fitzgerald Miller. The power of partnership to shape the future of nursing: the evolution of the clinical nurse leader. Journal of Nursing Management. July 2008-Volume 16, Issue 5: 608–613.
Jukkala, A. et al. (2010). The Clinical Nurse Leader and Rural Hospital Safety and Quality. Online Journal of Rural Nursing and Health Care, vol. 10, no. 2, Fall 2010.
Lutfiyya, M.N., Sikka, A., Mehta, S., & Lipsky, M.S. (2009). Comparison of US accredited and non-accredited rural critical access hospitals. International Journal for Quality in Health Care, 21(2), 112-118.
Rousel, L. (2010). Clinical Nurse Leader Role. London: Jones& Bartlette Publishers.
Thompson, P.L and Kevin.D. (2007). Clinical Nurse Leader and Clinical Nurse Specialist Role Delineation in the Acute Care Setting. Journal of Nursing Administration: October 2007 – Volume 37 – Issue 10 –: 429-431.