Leadership is intrinsic to nursing. Nurses at all levels make decisions and perform tasks that save lives, but the field holds additional opportunities for those who excel at guiding and inspiring others.
Formal nursing leadership roles involve practicing advanced care, innovating solutions, and influencing operations and policy.
Types of Nursing Leadership
The field of nursing features many types of leadership roles. Some focus on direct patient care, while others consist of managerial and administrative functions.
Nursing Leadership in Clinical Settings
Nurse leaders in clinical settings focus on patient care, performing many of the functions commonly associated with other medical professionals. For example, advanced training qualifies nurse practitioners to diagnose, treat, and prescribe medications to patients.
The expertise of these nurse leaders allows them to assess nursing practices and innovate care programs. Nurse leaders in clinical settings also foster reflective practices among nursing teams, stepping back from their work to note successes and areas of improvement that can inform future practice. They serve as knowledge resources in specialty areas and in general medicine, dealing with not only care delivery but also the assessment of treatment results. Their work improves patient outcomes and the efficiency of healthcare organizations.
Administrative and Managerial Nursing Leadership
Nurse leaders play vital roles in administrative and executive positions as well. These leadership positions may be strictly managerial or involve a combination of clinical and administrative responsibilities. Nurse leaders carry out a wide variety of administrative and managerial functions:
- Human Resources and Financial Management. Nurse leaders make hiring and firing decisions. They also organize staff training, foster professional development, and prepare budgets.
- Quality-of-Care Standards. Nurse leaders oversee nursing units, ensuring nurses follow established protocols and procedures that maintain patient safety and high-quality care.
- Organizational Goals. Nurse leaders set goals for patient outcomes. They align nursing units’ goals with their healthcare organizations’ larger strategic objectives.
- Patient and Nurse Advocacy. Nurse leaders communicate nursing units’ needs to management. They represent nurses in meetings with their healthcare organizations’ executive leaders. They also advocate for patients, working to improve their satisfaction and ensure a safe environment.
Nursing Leadership Roles
Nurses interested in pursuing leadership positions can choose from a range of career paths that lead to both clinical- and administrative-focused roles.
Advanced Practice Registered Nurses
The four types of advanced practice registered nurses (APRNs) diagnose and manage patient problems. They can order tests and prescribe medications.
- Certified Nurse Practitioner (CNP). CNPs are independent practitioners of advanced care. Their responsibilities include disease prevention, health education, the diagnosis and management of acute and chronic diseases, and general health promotion.
- Clinical Nurse Specialist (CNS). Clinical nurse specialists address the diagnosis, treatment, management, and prevention of diseases. They focus on nursing practice and healthcare organizations and systems, in addition to patient care.
- Certified Registered Nurse Anesthetist (CRNA). CRNAs provide anesthesia care for a range of patients, from healthy people to patients with a life-threatening illness or injury.
- Certified Nurse-Midwife (CNM). CNMs provide gynecologic, preconception, prenatal, postpartum, childbirth, and newborn care, as well as family planning services.
Chief Nursing Officers
Chief nursing officers (CNOs) and chief nursing executives (CNEs) develop and assess practices that improve patient safety and nursing care. They also have human resource responsibilities and serve as a liaison between executive management and nursing departments.
Clinical Nurse Leaders
Clinical nurse leaders typically oversee the care of patient groups, although they also provide direct patient care in some situations. CNLs are responsible for putting evidence-based practices in place, evaluating patient outcomes, and conducting risk assessments. Serving in a clinical role, the CNL coordinates care with physicians, pharmacists, social workers, clinical nurse specialists, and nurse practitioners.
Nurse managers supervise nursing staff, ensuring they adhere to best practices and procedures. Duties include offering guidance to nurses during crises, addressing concerns about patient safety, and monitoring compliance with policies and regulations. Nurse managers decide patient care practices, but their focus is administrative.
Nurse Leadership Competencies
The varied duties and responsibilities of nurse leaders require a broad range of skills. In addition to extensive experience with clinical practice, nurses develop knowledge of healthcare policies, economics, governance, and strategy. Leadership roles also demand competency in high-level organizational analysis, problem-solving, and change management.
Nurse leaders serve as role models in their organizations, and upholding ethical standards is of paramount importance. Their position as leaders requires strong communication and interpersonal skills. It also comes with a responsibility to promote equity in healthcare.
Nurse leaders must effectively communicate information about care practices, departmental needs, and organizational policies and issues. In clinical settings, they communicate treatment plans, diagnoses, and test results to patients and other healthcare providers. They also collaborate with doctors, pharmacists, social workers, and other nurses to implement evidence-based care.
Nurse leaders build trusting, collaborative relationships with nursing staff, patients, and other healthcare leaders. This requires demonstrating empathy, asserting opinions in nonjudgmental ways, accepting and offering criticism constructively, and meeting promises and commitments.
Diversity and Inclusion
As nurses take on greater responsibilities, they have more opportunities to address healthcare disparities. Nurse leaders create environments that recognize and value the diversity of patients and staff. This involves identifying and implementing culturally sensitive practices, assessing progress toward cultural competency, and addressing inappropriate actions and attitudes toward marginalized communities.