Nursing students in an expanded charge nurse role: a real clinical management experience

Ensuring that baccalaureate nursing students obtain a measure of management and leadership proficiency is a challenge for nurse educators. Having senior students manage juniors in a clinical course modeled in a peer hierarchal pattern that emulates advanced beginner practice is a creative approach that is both realistic and achievable. Through specific learning experiences, students are exposed to typical management functions and asked to demonstrate management and leadership skills at an expanded charge nurse level.     

护理专业学位硕士研究生临床实践能力指标体系的研究

目的构建我国护理专业学位硕士研究生临床实践能力的指标体系。方法采用Delphi法从全国范围选择45名专家进行两轮函询。结果专家积极性高,两轮函询问卷有效回收率分别为80.00%和91.67%;专家的权威程度系数分别为0.85、0.89;第2轮一级指标和二级指标的协调系数分别为0.284、0.262。最终形成包含6个一级指标,即:临床专科护理能力、教育能力、提供咨询能力、研究能力、临床和专业领导能力和自我管理能力及34个二级指标的护理专业学位硕士研究生临床实践能力指标体系。结论初步确定了护理硕士专业学位研究生临床实践能力的指标体系,为日后形成护理专业学位硕士研究生培养方案提供科学依据。     

Nursing practice problems in private hospitals in Jordan: students' perspectives

This paper grew from an exploration of clinical practice problems in a private hospital in Jordan. Senior nursing students in a governmental university studied these issues while focusing on leadership and management issues. The private sector is of a secondary focus in nursing research. In Jordan, nursing studies that explore the nursing profession and its related issues have been limited in the literature. A student assignment in the "Nursing Leadership and Management" course required the students to work in groups to identify a nursing practice problem, and its contributing causes and suggested solutions. The nursing shortage; job dissatisfaction; burnout; and turnover were the identified nursing practice problems. Causes and solutions of these problems were explored.     

Developing leadership in nursing: exploring core factors

This article provides an introduction to the issue of nursing leadership, addressing definitions and theories underpinning leadership, factors that enhance leadership in nursing, and the nature of leadership content taught in undergraduate programmes. Highlighted are differences between leadership and management, and the notion that leadership can be 'learned'. The authors also point out that there is a discrepancy between how leading undergraduate nursing programmes prepare students primarily in the transition of education to practice, and the suggestion from a number of nursing publications that leadership in nurses should be fostered throughout their education.     

Nursing practice issues in Jordan: student-suggested causes and solutions

BACKGROUND: The causes of the worldwide shortage of registered nurses are complex and require a multifaceted approach to the solution. It is imperative that issues of the practice environment are addressed because creating quality practice environments is essential to provide high-quality care and to persuade nurses to remain in practice. AIMS: The aims of this paper are to describe an international collaborative relationship, and to identify, describe and suggest solutions to three nursing practice issues relevant to Jordanian nursing. METHOD: Two faculty members, one from Jordan and one from Canada, collaborated via e-mail to develop a fourth-year course on nursing leadership and management, which was then jointly taught by them. A student assignment required students, working in groups, to identify a nursing practice issue in Jordan and suggest contributing causes and solutions. CONCLUSION: The issues identified by the students were: unclear role expectations, burnout and turnover, all of which were viewed as contributing to problematic practice settings. The students suggested possible solutions to the practice environment issues.     

Director of nursing and midwifery leadership: informed through the lens of critical social science

solman a . (2010) Journal of Nursing Management 18, 472–476
Director of nursing and midwifery leadership: informed through the lens of critical social science Aims Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Background Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Key issues Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Conclusion Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. Implications for nurse management This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work.     

Assisting nurses to facilitate student and new graduate learning in practice settings: What ‘support’ do nurses at the bedside need?

The behaviours of nurses in the community of practice that new graduates and students participate directly contribute to learning. These behaviours are becoming more important with increasing numbers of students and graduates learning in health care contexts. Nurses, whether they assume the role of preceptor, buddy or mentor are pivotal in identifying appropriate learning opportunities for students and graduates, and assimilating these learners into the team. As nurses at the bedside have a designated caseload they need to be supported to perform this important role while delivering health care. The literature reports a number of constraints for nurses when facilitating the learning of others, namely, inadequate preparation about how to foster learning in this context, poor planning at the ward level, lack of reward or recognition for the role, lack of understanding about the specific learning needs of students and new graduates. This discussion paper provides direction for leadership and management teams to effectively support nurses who assume the role of preceptor, buddy or mentor to assist others' learning in the workplace. The recommendations suggest management teams provide for adequate preparation of nurses, effective planning of workload and organisation of work in the clinical area, and mechanisms for timely and specific feedback to maintain nurses interest and motivation in performing the role. Furthermore, senior leadership personnel need to establish a culture where the value of teaching and learning in practice is recognised and fostered by the entire team.     

Beyond myth and magic: the future of evidence-based leadership

Leaders must understand the essential characteristics and realities of creating an evidence-driven organization. It is especially important to comprehend and apply sound leadership and management of infrastructure, processes, and behaviors that incorporate evidence in every aspect of clinical practice. Evidence-driven practice is no longer optional and is now a fundamental leadership requisite in all clinical settings.     

Nursing students perceptions of desirable leadership qualities in nurse preceptors: a descriptive survey

There is a paucity of literature examining the context of leadership within the clinical preceptor/undergraduate nursing student relationship and the relevance of this to the clinical learning environment. This study used a mixed methodological survey approach to explore the leadership qualities in nurse preceptors that are considered desirable and contribute to positive practicum experiences from the perspective of 23 undergraduate nurses. Findings showed students both want and need leadership from their preceptors in order to develop psychomotor skill competency and to experience orientation to the real world of nursing care. Gaining insight into the leadership qualities that students perceive as desirable to enhance the practical experience is vital since that practical experience is viewed as the making or breaking of many students and influences retention in undergraduate education and within the profession post registration.     

The clinical nurse educator as leader

The National League for Nursing recognizes leadership as an important aspect of the educator role. The purpose of this article is to describe leadership in the context of clinical nursing education and how clinical nurse educators enact leadership. The article identifies particular nursing practice skills and strengths that clinicians bring to nursing education that enhance leadership knowledge, skills, and abilities. After review of several leadership models, we identified five overarching themes that demonstrate how clinical nurse educators exemplify the various models including role modeling, providing vision, helping students to learn, challenging the system or status quo, and seeking relational integrity. We explicate the themes with examples affirming the leadership potential of clinical nurse educators, and suggest ways in which nursing faculty members and administrators might draw on the leadership capital of clinical nurse educators.     

A framework to develop a clinical learning culture in health facilities: ideas from the literature

HENDERSON A., BRIGGS J., SCHOONBEEK S., & PATERSON K. (2011) A framework to develop a clinical learning culture in health facilities: ideas from the literature. International Nursing Review 58 , 196–202 Background: Internationally, there is an increase in demand to educate nurses within the clinical practice environment. Clinical practice settings that encourage teaching and learning during episodes of care delivery can be powerful in educating both the existing nursing workforce and nursing students. Aim: This paper presents a framework, informed by the literature, that identifies the key factors that are needed to encourage the interactions fundamental to learning in clinical practice. Key concepts: Learning occurs when nurses demonstrate good practice, share their knowledge through conversations and discussions, and also provide feedback to learners, such as students and novices. These types of interactions occur when positive leadership practices encourage trust and openness between staff; when the management team provides sessions for staff to learn how to interact with learners, and also when partnerships provide support and guidance around learning in the workplace. Application of concepts: This framework presents how the concepts of leadership, management and partnership interact to create and sustain learning environments. The feedback from proposed measurement tools can provide valuable information about the positive and negative aspects of these concepts in the clinical learning environment. Analysis of the subscales can assist in identifying appropriate recommended strategies outlined in the framework to guide nurses in improving the recognized deficits in the relationship between the concepts. Conclusion: Leadership, management and partnerships are pivotal for the creation and maintenance of positive learning environments. Diagnostic measurement tools can provide specific information about weaknesses across these areas. This knowledge can guide future initiatives.     

A scoping review to understand “leadership” in interprofessional education and practice

This scoping study examined how “leadership” is referred to and used in interprofessional education and practice. A total of 114 refereed articles were reviewed to determine how leadership is defined, conceptualised, and theorised. The review also examined what capabilities were identified for effective interprofessional leadership. The majority of papers were empirical studies undertaken by researchers based in North America. The majority of articles did not refer to a specific leadership approach, nor did they define, describe, or theorise leadership. Moreover, “leadership” capabilities were rarely identified. Articles generally focused on health practitioners and educators or students as leaders with little exploration of leadership at higher levels (e.g. executive, accrediting bodies, government). This review indicates the need for a more critical examination of interprofessional leadership and the capabilities required to lead the changes required in both education and practice settings. The goal of this article is to stimulate discussion and more sophisticated, shared understandings of interprofessional leadership for the professions. Recommendations for future research are required in both education and practice settings.     

Using the patchwork text assessment as a vehicle for evaluating students' perceptions of their clinical leadership development

A shift in universities world wide in providing theoretical post graduate programmes of study underpinned by traditional assessment strategies to work based learning programmes supported by innovative assessment strategies is required if Higher education institutions are to effectively educate contemporary healthcare leaders. Concurrently generating the evidence to evaluate the effectiveness of educational programmes is required by commissioners of healthcare education (DH, 2010).This paper reports on the perceptions of twelve post graduate students attending a clinical leadership masters programme of their leadership development through analysis of the critical commentary provided by students as part of assessment strategy that utilised the Patchwork Text Assessment.Following a thematic content analysis six themes emerged: programme philosophy and its impact on the success of the Patchwork Text Assessment; leadership development targeted against leadership frameworks; application and applicability of learning to the students own healthcare organisation; integrating theory to practice through theoretical development and work based activities; the value of networking; and the importance of multi-professional reflective groups.This study has clearly demonstrated how the success of the Patchwork Text Assessment in promoting deep learning is determined by its integration into the overall philosophy of the programme. Concurrently systems needed to be in place to ensure that Patchwork text Assessment is operationalised effectively and embedded within the day to day management of the programme.     

Promoting leadership and management in Australian general practice nursing: what will it take?

Aim This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Background Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. Conclusions The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. Implications for nursing management There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.     

The Leadership Role of Nurse Educators in Mental Health Nursing

Leadership behaviors and actions influence others to act, and leadership in clinical practice is an important mediator influencing patient outcomes and staff satisfaction. Indeed, positive clinical leadership has been positioned as a crucial element for transformation of health care services and has led to the development of the Practice Doctorate Movement in the United States. Nurse educators in health care have a vital leadership role as clinical experts, role models, mentors, change agents, and supporters of quality projects. By enacting these leadership attributes, nurse educators ensure a skilled and confident workforce that is focused on optimizing opportunities for students and graduates to integrate theory and practice in the workplace as well as developing more holistic models of care for the consumer. Nurse educators need to be active in supporting staff and students in health care environments and be visible leaders who can drive policy and practice changes and engage in professional forums, research, and scholarship. Although nurse educators have always been a feature of the nursing workplace, there is a paucity of literature on the role of nurse educators as clinical leaders. This discursive article describes the role and attributes of nurse educators with a focus on their role as leaders in mental health nursing. We argue that embracing the leadership role is fundamental to nurse educators and to influencing consumer-focused care in mental health. We also make recommendations for developing the leadership role of nurse educators and provide considerations for further research such as examining the impact of clinical leaders on client, staff, and organizational outcomes.     

A health promotion practicum targeting the college-age population

Senior and sophomore baccalaureate nursing students at the University of Kentucky developed a health promotion exposition that targeted college students. This experience gave senior students the opportunity to practice leadership and management skills, such as planning, organizing, collaborating, delegating, evaluating, and time management and conflict resolution. Sophomore students developed teaching abilities, practiced assessment and communication techniques, and increased their knowledge of health-promoting behaviors. Both groups experienced team building and demonstrated accountability. Students reported a positive learning experience that met various course objectives in an innovative way.     

Videoconferencing and Web-based conferencing to enhance learning communities

Preparing nursing students to develop the leadership and management skills necessary to adapt to ever-changing practice environments is a challenge for educators. Videoconferencing and Web-based conferencing allow for expansion of traditional classroom walls to develop partnerships among peers, exchange perspectives, and gain a more global understanding of nursing care delivery systems. A collaborative leadership seminar using videoconferencing was used to connect two large colleges of nursing in the midwestern United States, and through Web-based conferencing, one of the midwestern colleges was connected to a university in the United Kingdom. Objectives for students were exposure to different schools of thought, management of care via technology, network and cultivation of global perspectives on health care delivery, and experience of novel educational approaches.     

Clinical Simulation Augments Traditional Interviewing of Advanced Practice Provider Candidates

An essential role of critical care advanced practice providers—advanced practice registered nurses and physician assistants—is to have knowledge and competency to make accurate and efficient decisions. The ability to manage clinical scenarios involving medically deteriorating patients requires higher-order cognitive thinking and leadership skills that are challenging to extrapolate in traditional interviews. In critical care, advanced practice providers must make rapid clinical assessments and implement appropriate medical interventions to deter progression of life-threatening illnesses. Adding clinical simulation to the traditional interview allows interviewers to evaluate applicants’ crisis resource management skills, leadership, and clinical competency.     

Extended immersive simulation to develop nontechnical skills: Content analysis of students' views

BackgroundThe purpose of undergraduate nursing education is the preparation of graduates for clinical practice. Despite this focus, graduates are often unprepared for independent practice, particularly in the use of skills such as time management, delegation and critical thinking in clinical situations. This paper reports on students’ views of using extended, immersive simulation to consolidate the use of both technical and nontechnical skills in preparing them for independent nursing practice.AimTo investigate students’ views on the value of extended, immersive simulation in preparing them for independent practice as registered nurses.MethodsCross-sectional research involving content analysis of open-ended survey questions. The study involved comments from 287 final year nursing students conducted at a university in Western Australia.FindingsThemes related to critical thinking, the role of the registered nurse, communication, time management, teamwork and leadership were identified through the content analysis. Students believed exposure to extended simulation facilitated development of the essential skills required to practise independently and helped them prepare for the role of a registered nurse. Many expressed the wish for this type of simulation to be included throughout all years of the nursing curriculum.DiscussionStudents need experience in clinical situations where they are challenged to use multiple skills simultaneously to develop the expertise required of registered nurses. The ability to practise independently, and take responsibility for decisions made in complex ward conditions, is not currently required of students on clinical placements. Simulation is a way to fill this void in nursing education to enable students to experience the full role of a registered nurse.ConclusionBased on our findings nursing students believed that extended, immersive simulation was an effective method of supporting students as they undertake the full responsibilities of registered nurses to enable them to be safe and effective practitioners on commencement of the registered nurse role.