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March 3, 2015

Why nurses don't get to be leaders

Daily Briefing

There are nearly 3.5 million nurses in the U.S., but the profession is significantly underrepresented in hospital leadership, which can affect employee engagement and the patient experience, two nurse leaders said in an interview with Becker's Hospital Review.

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Background on nurse leadership

According to Becker's, nurses—health care's largest labor sector—play an important role in clinical outcomes, patient satisfaction, and employee retention. Moreover, nearly 80% of Americans ranked nurses as having "very high" or "high" standards of honesty and ethics, while just 65% said the same of physicians.  

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But despite the critical role nurses play in health care, they remain underrepresented on hospital boards and in hospital c-suites. In fact, a recent study published in the Journal of Healthcare Management found that just 6% of hospital board governors are nurses. 

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Creating nurse-led hospitals

Nancy Robert, executive VP and chief product and marketing officer for the American Nurses Association, and Christy Davidson, interim dean of the school of nursing and health sciences at Capella University, say nurses often are not seen as substantial decision-makers compared to their physician counterparts because there is a misperception of what nurses actually contribute to hospitals. To change that, "We need to make a big, big drive to educate people and counteract those perceptions" by developing nurse-led systems, the nurses argue.

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Chiefly, Robert and Davidson say that hospitals should engage more nurses in leadership roles where they are involved in decision-making and own projects. At institutions that are not nurse-led, nurses are often thought of simply as "task-doers" and wait for issues to be resolved as opposed to offering ideas to resolve them.

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In addition, the nurses say hospitals should be more consistent in defining the roles of nurse leaders and provide clarity across the board. This would facilitate leadership training for nurses. Davidson notes, "We do need to do a better job at succession planning at all levels so we have leadership tracks in different parts of an organization" and "recognize the need for appropriate onboarding and fostering an environment of ongoing leadership development."

The benefits of clinician collaboration

The Institute of Medicine's "Future of Nursing Report" found that nurse-led hospitals, or those with strong nursing leadership, foster more collaborative environments that tend to report better patient outcomes. Nurses should "be full partners with physicians and other health care professionals in redesigning health care," the report says.

Robert explains, "When you have relationship-based leadership, you open up and leverage the talents of every one, down to every nurse who interacts with patients at the bedside." Doing so leads to more engaged nurses and lower nurse turnover because nurses feel that their voices are heard and valued.  

According to Robert and Davidson, organizations with strong nurse leadership tend to see improved patient satisfaction scores. "They can tell when the nurses are happy," Davidson says, adding, "You can tell when staff is cared for and secure in what they are able to do" (Gamble, Becker's Hospital Review, 2/25).

The takeaway: Hospitals with nurses in the leadership ranks tend to see higher levels of patient satisfaction and lower turnover rates. Two nurse leaders explain how hospitals can help nurses become more involved in decision-making—and how nurses can make their voices heard.

How to better engage your nursing staff

Recent Advisory Board research revealed that nurses are among the least engaged of all employees within the health care workforce. Why is this? And, more importantly, what can we do about it?

In this webconference you can:

  • Resolve solvable challenges nurse leaders can address to improve frontline engagement in today's complex operating environment
  • Learn about nurse engagement hot spots, or subgroups of nurses you might need to take a closer look at—and how to apply our engagement strategies to these groups
  • Uncover executive strategies and best practices for overcoming the first two solvable challenges to an engaged workforce.


More from today's Daily Briefing
  1. Current ArticleWhy nurses don't get to be leaders

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