Managing Change as a Nursing Leader

Nurse Leaders in Executive Practice

Introduction

Nurse leaders in executive practice are the force behind the vision for nursing practice. They oversee the management and delivery of safe, timely, efficient, equitable patient-centered care. With their help, collaborative and interprofessional relationships are built among professionals in the healthcare industry, and patients benefit from the improved level of care that follows. Overall, thanks to nurse leaders in executive practice, population health can be promoted and healthcare costs reduced. To support these ends, the American Organization for Nursing Leadership (AONL) has its Nurse Executive Competencies, which represent the necessary skills that nurse leaders in executive roles should acquire and possess. These competencies were developed in collaboration with the Healthcare Leadership Alliance in 2004 and can be considered the most important educational domains essential for effective healthcare leadership for nurses.

The Vision for Nursing Practice

Nurse executives are responsible for communicating a clear vision for nursing practice. That vision should correspond with the goals of the healthcare organization. The vision is important for nursing staff because it is what allows them to realize the importance of providing the kind of quality care expected of professionals. Nurse executives must establish the reality of working towards the highest standards of care, because there is simply no other way for nursing practices to be able to contribute to patient and community improvements: the vision of a standard of excellence has to be there for them to follow.

Safety is the number one most important aspect of that vision of excellence. That is why nurse executives always prioritize patient safety through the recommendation of evidence-based practices (Engle et al., 2021). These practices help to create a culture of safety, and so long as staff comply with regulatory standards, this culture will help to create a solid nursing staff. At the same time, nurse executives bear responsibility for identifying any risks to safety and for developing mitigation strategies. They have to be continuously monitoring patient care processes and outcomes to make sure patient safety standards are being met.

Timeliness is another essential component of nursing excellence, as timely care prevents complications from arising (Sole et al., 2020). Nurse executives have to know how to streamline processes so that there are no unnecessary delays in care delivery. They will have to coordinate with other healthcare professionals to manage care resources.

In doing so, nurse leaders promote efficient care, which is yet one more essential component of nursing. Nurse leaders must take care for the maximizing of resources and the minimizing of waste. They have to know the areas where improvements can be made and how to come up with strategies for more efficient operations. Patient satisfaction hangs in the balance of such awareness on the part of nurse executives. Behind the scenes activities like improving workflow, reducing redundancy, workplace safety, positive culture, and communication among team members are all part of this competency (Clipper, 2023).

The next skill needed is the ability to bring equity to healthcare so that all patients have the same open access to quality care regardless of their situation. Nurse leaders must advocate for policies and practices that promote health equity, that address disparities, and that allow for care to be available to diverse populations.

To that end, patient-centered care is required. It is care designed to meet the unique needs of the individual. Nurse executives have to promote prioritizing patient-centered care via cultural competency, respect for patient autonomy, and making sure patients are involved in all decision-making processes. This is what improves patient satisfaction the most.

Collaborative and Interprofessional Environment

Nurse executives lead within a collaborative and interprofessional environment, working alongside different healthcare professionals to achieve common goals of patient-centered coordinated care. One of the goals of nurse executives is to improve the patient experience of care. Nurse leaders achieve this goal by focusing on quality-of-care delivery, patient feedback, implementing quality improvement initiatives, and establishing a patient-centered culture. Nurse executives also look beyond the walls of the organization at the wider population to see how they can improve the health of the overall community—which they can do by identifying and addressing public health issues, teaching about and promoting preventive health, launching community health programs, expanding access to care, and increasing health literacy. To succeed in these endeavors nurse leaders need to collaborate with other healthcare professionals and community leaders (Clipper, 2023).

Another one of the responsibilities of nurse leaders is to lower the per capita cost of healthcare. Cost management is the main way to do this. Nurse leaders should know how to be financially responsible so that the organization can operate but at the same time make sure patients receive the highest quality care possible.

AONL Nurse Executive Competencies

The AONL Nurse Executive Competencies represent a framework for nurse leaders in executive roles. These competencies include several domains, such as communication, relationship management, knowledge of the healthcare environment, leadership, professionalism, and business skills.

Effective communication and relationship management can be supported by good, strong interpersonal skills. This allows nurse leaders to develop and maintain relationships. Being a good communicator means know how to engage in active listening, resolve conflicts, inspire others, and motivate teams.

Having a comprehensive understanding of the healthcare environment is another core essential competency for nurse leaders. The nurse must know about healthcare policies, regulations, trends in care, evidence-based care, and the social, economic, and political factors that influence policies and community health (i.e., the social determinants of care). Nurse executives must be informed about changes in the industry, regulations, and overall population health, so that strategies are in place when needed. The idea is to be proactive rather than reactive (Engle et al., 2021).

Leadership is also a core competency for nurse executives, due to the need to establish a vision and lead organizational change. Nurse leaders must have integrity, character, the ability to make ethical decisions, and to lead by example. They must also be able to plan strategically, think critically, manage change, build teams, and obtain buy-in. The nurse leader must be a complete leader (Clipper, 2023).