The Institute of Medicine in its landmark Future of Nursing: Leading Change, Advancing Health report called on nurses and nursing associations to prepare the nursing workforce to assume leadership positions. In the nearly five years since its release, many organizations have taken that recommendation to heart, offering formal programs to develop frontline nurses leadership skills. Bedside nurses are at the point of care and often see opportunities for improvement, but many feel unprepared to lead in the environment of healthcare we have now, said Marian Altman, MS, RN, CNS-BC, ANP, a clinical practice specialist at the American Academy of Critical-Care Nurses. She also is a faculty member at the AACN Clinical Scene Investigator Academy, which provides participants with skills while inspiring and empowering staff nurses to become leaders and change agents, who influence and guide their peers, Altman said.
Participating nurses create projects to improve patient outcomes. The teams also attend educational sessions during the 16 months. The curriculum includes content on leadership skills, culture change, problem identification and solutions, social entrepreneurship, data analysis, communication skills, sustaining results and sharing solutions at conferences.
CSI Academy participants will tell you how they feel empowered now, Altman said. They know how to affect their daily practice. They have confidence in their skills and abilities. Their clinical judgment has skyrocketed. They found their voice and are not afraid to step up and initiate improvements. They know how to collaborate better. Weve seen collaboration not only among nurses on a team but between teams in a cohort city.
Care innovation and transformation
Nurses also are gaining confidence through implementing change as part of the American Organization of Nurse Executives Center for Care Innovation and Transformation, a two-year program teaching frontline nursing staff and unit-based leaders how to generate ideas for change and to rapidly implement those ideas on a small scale, said Amanda Stefancyk, MSN, MBA, RN, CNML, director for the center.
CIT teams learn about performance improvement, innovation, conflict resolution and leadership. Successful projects have taken on linen management, increasing nursing wages and emergency department follow-up care, as well as other topics.
In only a few short months after beginning the CIT program, bedside nurses are demonstrating confidence in their knowledge and making changes, Stefancyk said.
Every nurse is a leader
The management team at Presence Saint Joseph Medical Center in Joliet, Ill., feels so strongly about bedside leadership, it has structured its nursing vision around an every nurse is a leader philosophy, reported Lynn Watson, MSN, RN, CMSRN, director of professional nursing practice and development at Presence Saint Joseph.
The hospital developed the Growth and Advancement in Nursing program to facilitate nursing leadership skills at the point of care. It consists of a core curriculum that includes leadership traits/characteristics, delegation and communication, such as crucial conversations and giving feedback. Participants then identify a process for continued leadership development.
Leadership through shadowing
The Miriam Hospital in Providence, R.I., created a Charge RN Competency program for bedside nurses who step into the charge role. They participate in 12 hours of classroom training and spend at least eight hours shadowing charge nurses and supervisors, to improve their conflict management skills and ability to give and receive feedback, as well as develop other leadership abilities, said Ann M. Barrett, MBA, RN, NE-BC, director of nursing resource management at Miriam.
The nurses love it, Barrett said. The nurses felt better, and the managers and supervisors said [the participants] are making better decisions and [are] more confident about their decisions.