The role of clinical nurse leaders

1. The role of clinical nurse leaders Allison Peters, BSN, RN, CNOR University of Central Florida

2. Assessing the need for Clinical Nurse Leader • Clinical Nurse Leader (CNL) is a relatively new role developed by the AACN (American Association of Colleges of Nursing • First new role to be added to nursing in over 35 years • Developed in response to unsafe care environment, gaps in communication, numerous handoffs and discipline vs. patient centered care. • (Tornabeni, 2006)

3. Forces for Change • A complex health care system mired in science and medical technology • Health insurance companies increasing restrictions & decreasing patient’s access to health care • Patient’s receiving assembly line fragmented care • Nursing shortage & staff retention • Increased demands & responsibilities on unit directors Poulin-Tabor, Quirk, Wilson, Orff, Gallant, Swan & Manchester, 2008

4. What Was Discovered • Clinical Nurse Leaders evolving as a practice focused and collaborative with other disciplines • CNL’s as colleagues and scholars; the ‘attending’ of staff nurses • Responsible for patient driven, evidence based, outcome oriented nursing process. • Not an ‘add on’ to management or a replacement for the Clinical Nurse Specialist • Impacted not only patient outcomes but financial, educational and integral for staff satisfaction • (Ott, Haddock, Fox, Shinn, Walters, Hardin, et al., 2009).

5. Qualifications • Task force developed by AACN for academic and characteristic guidelines (Task Force on Education and Regulation for Professional Nursing Practice- TFER1) • TFER1 conclusion RN’s need to be masters level education to lead and guide practice care at point of care • Patient care delivery system redesigned to assure new skills and competencies are maximized • (Tornabeni, 2006).

6. Assumptions AACN defined ten assumptions associated with the CNL role: • Practice is at the Microsystems level • Client care outcomes are the measure of quality practice • Practice guidelines are based on evidence • Client-centered practice is intra-and interdisciplinary • Information will maximize self-care and client decision making • Nursing assessment is the basis for theory and knowledge development • Good fiscal stewardship is a condition of quality care • Social justice is an essential nursing value • Communications technology will facilitate the continuity and comprehensiveness of care • The CNL must assume guardianship for the nursing profession (AACN, 2007)

7. Characteristics • Committed to excellence • Effective communicator • Solutions oriented • Continuity of care • Spirit of inquiry • Compassionate • Passionate • Visionary • Team committed • Professional pride Improvement of nursing image, role model, mentor and coach to staff, stop victim mentality and enhance professionalism • . (Morgan, 2010).

8. Conclusion • Clinical Nurse Leader Role has a positive impact on the way nurses practice, patient’s lives and collaboration with other disciplines • Critical success of CNL program factor in the confrontation of current and future nursing shortages. • CNL will inspire faith, confidence, trust, collaboration and innovation • Crucial in attracting and retaining nurses • (Sherman, 2008)

9. Reference • American Association of Colleges of Nursing (AACN). (2007) White paper on the role of the clinical nurse leader. Retrieved October 29, 2010 from: http://www.aacn.nche.edu/Publications/WhitePapers/ClinicalNurseLeader.htm • De Casterlé, B., Willemse, A., Verschueren, M., & Milisen, K. (2008). Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study. Journal of Nursing Management, 16(6), 753-763. Retrieved from CINAHL Plus with Full Text database. • Morgan, B. (2010). What are the characteristics of a leader?. Dynamics, 21(1), 17-19. Retrieved from CINAHL Plus with Full Text database • Ott, K., Haddock, K., Fox, S., Shinn, J., Walters, S., Hardin, J., et al. (2009). The Clinical Nurse Leader (SM): impact on practice outcomes in the Veterans Health Administration. Nursing Economic$, 27(6), 363. Retrieved from CINAHL Plus with Full Text database. • Poulin-Tabor, D., Quirk, R., Wilson, L., Orff, S., Gallant, P., Swan, N., et al. (2008). Pioneering a new role: the beginning, current practice and future of the Clinical Nurse Leader. Journal of Nursing Management, 16(5), 623-628. Retrieved from CINAHL Plus with Full Text database. • Sherman, R. (2008). Factors influencing organizational participation in the CLINICAL NURSE LEADER project. Nursing Economic$, 26(4), 236. Retrieved from CINAHL Plus with Full Text database. • Tornabeni, J. (2006). Clinical nurse leader: evolution of a revolution. The evolution of a revolution in nursing. Journal of Nursing Administration, 36(1), 3-6. Retrieved from CINAHL Plus with Full Text database.