Let's get certified: best practices for nurse leaders to create a culture of certification

Certification benefits nurses, patients and their families, and hospitals. Nurses become certified for various reasons: personal challenge; self-improvement; advancement of knowledge and education; demonstration of mastery of skills, knowledge, and abilities; and commitment to lifelong learning and career growth. However, there are also barriers to certification. Fear of test taking or failure and lack of resources or organization recognition are reasons many nurses cite for not becoming certified. Nurse leaders play a pivotal role in supporting nurses to obtain and maintain specialty nursing certification. Nurse leaders may promote certification, support nurses who are on their certification journey, and reward and recognize those staff that become certified. This article will share practices to increase the number of specialty certified nurses in your unit or organization.     

The first evaluation of the advanced practice nurse role in Finland - the perspective of nurse leaders

fagerström l. & glasberg a.-l. (2011) Journal of Nursing Management 19, 925–932 The first evaluation of the advanced practice nurse role in Finland – the perspective of nurse leaders Aims The aim of this study is to explore and describe nurse leaders’ (NLs) experiences of the role of advanced practice nurses (APNs). Background The first group of advanced practice nurses (17) in Finland graduated in 2006 and were thereafter employed by seven different organizations in more or less clearly defined advanced practice nurses roles. Methods Seven nurse leaders at the relevant organizations were interviewed a year after the introduction of the advanced practice nurses role. Content analysis was used to analyze the data. Results All of the nurse leaders emphasized the importance of the advanced practice nurses role in their organization. The advanced practice nurses’ scope of practice comprised a more autonomous and independent role than registered nurses. Advanced practice nurses are an important resource in the care of patients with chronic diseases and acute health problems. An important aspect regarding support for the advanced practice nurses role is the provision of information to all health-care personnel and patients about the role and clearly defined areas of responsibility. Conclusions Advanced practice nurses are an important resource in the development of evidence-based nursing and improve the availability of health-care services for patients. Implications for nursing management Nurse leaders are responsible for creating sustainable structures and the prerequisites needed for advanced practice nursing through the formation of supportive organizational systems.     

Exploring nurse education in Canada, Finland and the United States

A global registered nursing (RN) shortage has caused an increase in migration and international recruitment of nurses. There is growing interest among some countries of having common standards and competencies for entry-level registered nurses to guide future registered nurse agreements between countries or multi-country licensure programs. Nursing education in one country may not be accepted as equivalent for a nurse to become licensed in another country. An exploratory study was conducted to gain a better understanding of how nurses are educated in various countries. Nurse researchers sent a nursing education questionnaire to nurse educators in eleven countries inviting them to participate in the study. Nurse educators from six countries agreed to participate in the study. They provided information about their country's nursing history, types of nursing programs, use of national nursing licensing examination, and political influences on nursing education. The People's Republic of China, Japan and Turkey nurse educators' responses were the first to be analyzed and the results were published in the July/August 2005 issue of Contemporary Nurse (volume 19/1-2). This second article (in Contemporary Nurse volume 20/2) provides information about and a comparison of nursing programs in Canada, Finland and the United States.     

Program development: role of the clinical nurse specialist in implementing a fast-track postanesthesia care unit

Advanced practice nurses are involved in many aspects of program development as part of their roles. This can involve such things as developing programs for staff and family education, organizing system-wide quality assurance programs, or implementing new care programs. One unique aspect of the advanced practice nurse's role is the ability to serve as a change agent and implement new models of care. Although all advanced practice nurses can be involved in program development, the role of the Clinical Nurse Specialist lends itself to devoting dedicated services for implementing programmatic change in the clinical setting. This article describes the role of the Clinical Nurse Specialist in implementing an evidence-based, fast-track postanesthesia care unit.     

Employment implications of nurses going through peer assistance programs for substance use disorders

Nurses constitute approximately 36% of all healthcare providers, and 2% of the labor force in the United States (American Nurses Association [ANA], 2016). However, about 8% of nurses suffer from substance use disorders ([SUD]; Kunyk, 2015) and must participate in peer assistance programs to maintain their licenses (Darbro & Malliarakis, 2012). The purpose of this study was to describe the lived experiences of nurses with SUD participating in peer assistance programs and the subsequent employment implications. A Phenomenological approach was used to answer the research questions. Ten nurses were recruited from local support meetings and a thematic inductive approach was utilized to develop four overarching themes, which included stress from restriction, guilt and shame, gratitude for being caught, and keeping up with recovery. Understanding the challenges recovering nurses face when being incorporated into the workforce is important in implementing policies that facilitate a smooth transition.     

Listening to nurses' moral voices: building a quality health care environment

In this paper we describe a research project in nursing ethics aimed at exploring the meaning of ethics for nurses providing direct care with clients. This was a practice-based project in which participants who were staff nurses, nurses in advanced practice, and students in nursing were asked to tell us (or describe to us) how they thought about ethics in their practice, and what ethical practice meant to them. We then undertook to analyze, describe and understand the enactment of ethical practice, the opportunities for and barriers to such enactment, as well as the resources nurses need for ethical practice. We drew out implications of these findings for nursing leaders. We identified practice realities that create a climate for ethical or moral distress, and the way in which nurses attempt to maintain their moral agency. Practice realities included nurses' ethical concerns about policies guiding care; the financial, human and temporal resources available for care; and the power and conflicting loyalties nurses encounter inproviding good care. Maintaining moral agency involved use of a variety of ethical resources and the identification of resources needed to provide good care, as well as the processes used to enact moral agency. Nurse leaders are also moral agents. Important implications of these findings for nursing leaders are that they need moral courage to be self-reflective, to name their own moral distress, and to act so that their nursing staff are able to be moral agents. Nurse leaders need to be the moral compass for nurses, using their power as a positive force to promote, provide and sustain quality practice environments for safe, competent and ethical practice.     

Nurse manager support: what is it? Structures and practices that promote it

Professional nursing organizations identify nurse manager (NM) support of staff nurses as an essential component of a productive, healthy work environment. Role behaviors that constitute this support must be identified by staff nurses. In this mixed-method study, supportive role behaviors were identified by 2382 staff nurses who completed the investigator-developed Nurse Manager Support Scale. In addition, semistructured interviews were conducted with 446 staff nurses, managers, and physicians from 101 clinical units in 8 Magnet hospitals in which staff nurses had previously confirmed excellent nurse manager support. Through individual and focus group interviews with NM and chief nurse executives in the 8 participating hospitals, the organizational structures and practices that enabled NM to be supportive to staff were determined. The 9 most supportive role behaviors cited by interviewees were as follows: is approachable and safe, cares, "walks the talk," motivates development of self-confidence, gives genuine feedback, provides adequate and competent staffing, "watches our back," promotes group cohesion and teamwork, and resolves conflicts constructively. Supporting structures and programs identified by managers and leaders include the following: "support from the top," peer group support, educational programs and training sessions, a "lived" culture, secretarial or administrative assistant support, private office space, and computer classes and seminars.     

Measuring Professional Identity: A Nursing Practice Perspective

In the past 20 years, professional identity in nursing and scales associated with the term have been difficult and confusing to define. In 2018, a group of nurse leaders sought to define professional identity in nursing and subsequently created a new scale based on that definition. This new Professional Identity in Nursing Scale is currently being psychometrically tested with practicing nurses. Nurse leaders can start to think innovatively about how to use the scale with individual nurses as well as with a group in the work environment.     

The value of the political action committee: dollars and influence for nurse leaders

Nurse leaders play an important role in the shaping of healthcare policy and the care delivery models of the future. It is vital for nurse leaders to understand the role of money in politics and how donations to a candidate's campaigns can be beneficial in getting one's concerns addressed by Congress. The political action committee (PAC) is a major vehicle for campaign contributions for candidates from any party. This article will detail the following related to PACs: history and background information, government regulations, and why PACs are an important vehicle for nurse leaders to gain access and influence in Congress.     

Before operating room nursing journals: operating room nursing in the pages of the Canadian Nurse 1940-1960

The Canadian Nurses Association (CNA) values learning from nursing history to provide a contextual perspective in understanding how past events have shaped current nursing practice. Until the publication of operating room nursing journals, Canada's national nursing journal, The Canadian Nurse, served as an educational and professional resource for those nurses working in the operating room and for nurses whose work was related to, or connected with, the operating room. A historical review of early issues of The Canadian Nurse (first published in 1905) reveals a substantial amount of content related to operating room nursing in the twenty year period, beginning in the 1940s, that predated the existence of OR specialty journals. The content was, for the time, both detailed and informative. It was through this journal that operating room nurses, indeed all Canadian nurses, learned about new advances, employment opportunities, educational programs, professional associations, and the achievements of those in the profession. Operating Room Nursing, as an isolated and quickly emerging specialty, was introduced to other nurses via items in The Canadian Nurse journal.     

Developing the future nurse leaders of Fiji.

BACKGROUND: Nurse leaders in Fiji are currently involved in meeting the challenges of being at the forefront of an AusAID supported Health Sector Improvement process. Fiji is experiencing the same shortages of health professionals (including nurses) as is occurring internationally, while simultaneously striving to improve the quality of its health services. PRIMARY ARGUMENT: This paper provides information about the current situation in relation to health services in Fiji, and describes strategies being undertaken by the nurse leaders of Fiji to meet the challenge of leading an exciting reform process. James Cook University, School of Nursing Sciences, has been privileged to support the provision of contemporary leadership and management education for current and future nurse leaders in the Fiji Health Sector as a component of a current education program to educate registered nurses to bachelor level. This paper will provide an overview of the current Fiji Health Sector Improvement Program, with a particular focus on the preparation of nurse leaders. CONCLUSION: There is an ongoing need to understand beliefs and values, and styles of interaction and communication, and indeed, ideas about time. With collaboration between Australian academics and Fiji tutors from the Fiji School of Nursing, the program appears to be remarkably successful.     

The influence of nursing leadership on nurse performance: a systematic literature review

brady germain p. & cummings g.g. (2010) Journal of Nursing Management 18, 425–439
The influence of nursing leadership on nurse performance: a systematic literature review Aim The aim was to explore leadership factors that influence nurse performance and particularly, the role that nursing leadership behaviors play in nurses’ perceptions of performance motivation. Background Nurse performance is vital to quality patient care outcomes and nursing leadership behaviors have been linked to nurse performance. Evaluations A review of research articles that examined the factors that nurses perceived as influencing their motivation and performance was conducted. Eight studies were included in the final analysis. Key issues Nurses’ perceptions of factors that affect their motivation and ability to perform were grouped into five categories using content analysis: autonomy, work relationships, resource accessibility, nurse factors, and leadership practices. Nursing leadership behaviors were found to influence both nurses’ motivations directly and indirectly via other factors. Conclusion The review suggests that nurse performance may be improved by addressing nurse autonomy, relationships among nurses, their colleagues and leaders, and resource accessibility. Implications for nursing management Nursing managers and leaders may enhance their nurses’ performance by understanding and addressing the factors that affect their ability and motivation to perform.     

Clinical nurse specialists and the practice of community nurses

AIM: This paper presents the findings of a study of the roles of Clinical Nurse Specialists and community nurses working in primary care. BACKGROUND: Clinical Nurse Specialists are recognized internationally as expert practitioners who could facilitate the implementation of evidence-based practice. However, others may misunderstand their role and greater support may be required if organizations are to capitalize on the skills of Clinical Nurse Specialists. METHODS: Elements of 'Glaserian' grounded theory in a broadly ethnographic approach were used to gain an understanding of the perspectives of 22 Clinical Nurse Specialists working as tissue viability nurses or continence advisors and 19 district nurses in one health region in the United Kingdom. The data were collected in 2001-02. FINDINGS: Clinical Nurse Specialists were keen to use their expertise to inform the practice of community nurses. However, they encountered difficulties when seeking to introduce changes in practice. Although Clinical Nurse Specialists were acknowledged as enabling rather than deskilling community nurses, receptivity to Clinical Nurse Specialists' ideas was dependent on what community nurses viewed as their own roles. As advisors, Clinical Nurse Specialists were dependent on the use of persuasion and vicarious power to bring about desired changes. These approaches are consistent with traditional approaches to change management as opposed to contemporary approaches to practice development. CONCLUSION: If Clinical Nurse Specialists are to reach their full potential and use their expertise to inform the practice of others, organizations need to recognize these posts as central to practice development. In particular, a framework is required which enables practice developers to use more inclusive approaches when seeking to bring about changes in practice.     

Communication. Improving RNs' organizational and professional identification in managed care hospitals

Nurse administrators are searching for an expanded repertoire of strategies to attract and retain qualified nursing staff in today's managed care environment. This study examined hospital registered nurses' interpretations of managed care and the effects of those views on nurses' identification with their employing organization and the nursing profession. Findings show that nurses held greater identification with their occupation than their organization. Significant factors influencing nurses' attachment to both of these reference groups included uncertainty about managed care changes, information received about managed care changes, and effects of managed care on the nursing role. Communication principles and strategies are presented to nurse leaders for use in fostering a stronger organizational affiliation among staff nurses while maintaining a strong identification with the nursing profession.     

They answered the call: Nebraska nurses join the ranks in World War II

On December 7, 1941, there were fewer than 1,000 nurses in the Army Nurse Corps. That infamous day, 82 of those brave nurses were stationed in Hawaii. Their bravery, leadership and calmness under extreme duress foreshadowed the amazing role nurses would play in World War II. In the months and years that followed Japan's bombing of Pearl Harbor, over 59,000 American nurses would answer the call and join the Army Nurse Corps. Courageous Nebraskan women were among them.     

Ageism in nursing education: A review of the literature

This literature review defines ageism, discusses attitudes of ageism and factors related to attitudes of ageism among nurses and student nurses, and describes educational interventions aimed at addressing ageism among undergraduate nursing students. A major gap in the literature was identified as no studies included associate degree nursing students or students in Registered Nurse to Bachelor of Science in Nursing bridge programs. Nurse educators can use evidence to address ageism in programs of nursing. Additional research is needed in underrepresented populations.