More Nurse Leaders Are Needed

In a healthcare system that is becoming increasingly more complex, there is a critical need for nurses in leadership roles. Nurses are in a prime position to serve as leaders because of their vast knowledge of patient care and healthcare delivery systems. There are multiple ways for nurses to contribute as leaders, whether they work in patient care or administrative roles.

Why We Need More Nurse Leaders

More Americans have healthcare coverage, which means more nurses are needed

The nation’s healthcare system has undergone a major overhaul in a relatively short period of time, much of it fostered by the Affordable Care Act of 2010. There is a massive new demand for quality healthcare; in a recent press release, the U.S. Department of Health & Human Services reported that 20 million Americans gained access to health coverage between 2010 and 2016. This influx of patients has occurred in the midst of a nursing shortage, a trend the American Association of Colleges of Nursing (AACN) anticipates will continue.

In The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (renamed National Academy of Medicine [NAM] in 2015) identified other contributing factors, including an aging population and a surge in chronic illnesses, such as cardiovascular disease and diabetes. The increase in chronic illness has caused problem for a system that was originally designed to primarily treat acute conditions.

Meeting these challenges and redesigning the healthcare system requires capable leadership. Nurses have working knowledge of patients’ needs and systems that need improvement. One of the IOM’s key recommendations is that nurses should be in leadership roles, acting as full partners and collaborators with physicians and other health professionals.

All Nurses Are Leaders

All nurses are leaders, regardless of their roles or levels of education. According to All Nurses Are Leaders, unlike managers, leaders may not have the roles or titles one thinks of as leadership positions. In addition to being resilient, empathetic and purpose-driven, nurse leaders have many other important characteristics.

Lifelong Learner

New healthcare delivery methods, technologies and other changes demand lifelong learning. There are different ways to seek continuing education, including joining professional nursing organizations, reading peer-reviewed journals and taking continuing education courses.

Patient Advocate

Nurses are morally and legally obligated to speak up for patients, even when it is difficult or inconvenient.

Critical Thinker

Nurses must follow certain protocols, but not every situation goes according to plan. Being able to think non-linearly, prioritize issues, solve problems and make prudent decisions are all essential skills.

Supportive Team Member

There are different ways to support other healthcare professionals, including teamwork, mentoring and emotional support.

Where Are Nurse Leaders Needed?

According to the IOM, nurses are necessary to maintain a more complex healthcare system. Further, according to DiscoverNursing, nurses who earn BSN degrees take on more complex roles in higher stakes situations. When working in direct patient care, a BSN-prepared nurse may develop nursing care plans, assist doctors, educate patients and supervise other nurses.

The healthcare system needs nurse leaders to work in other capacities as well: shaping health policy, designing improvement plans and implementing information technology. These new nursing roles require highly developed leadership skills, which the online Bachelor of Science in Nursing program (BSN) at the University of California San Marcos can help students develop.

Nurse leaders are also necessary in executive positions at hospitals. According to DiscoverNursing, nurse executives have multiple roles. As mentors to other nurses, they encourage creative thinking, help provide the best patient care and effectively communicate the organization’s mission. As administrators, they develop budgets, design and manage patient care, and shape healthcare policies.

There is also a critical need for nurses on hospital boards, yet Campaign for Action reports that only six percent of hospital board members are nurses — according to a 2011 American Hospital Association survey of more than 1,000 boards.

In addition, nurse leaders are necessary to help propel healthcare system change by working in a number of non-traditional roles. For instance, nurse informaticists are specialists who combine nursing science with technology to help manage essential medical data, train other nurses on systems and develop medical technology.

The Value of Nurse Leadership

The nation’s healthcare system would not be able to function effectively without nurse leaders. They contribute to the system in many ways.

Nurse leaders can give nurses a voice in the delivery of patient care, according to The Online Journal of Issues in Nursing. They can engage and mentor staff, creating a supportive work culture that benefits nurses and patients. At a time of critical nurse shortages, investing in nurses has never been as important.

Nurses have the most practical knowledge of direct patient care and the healthcare system, giving them a unique perspective. Nurses on hospital boards can help drive quality patient care and save hospitals money. According to Campaign for Action, “Nurses can point out the potential implications of a seemingly cost-saving decision and bring the perspective of someone who has worked on the front lines of patient care.”

Nurses who participated in the American Association of Critical-Care Nurses’ Clinical Scene Investigator (CSI) Academy, a 16-month leadership and innovation program for staff nurses, are an example of nurse leadership in action. They developed initiatives that have had substantial impact on clinical outcomes and saved approximately $28 million annually for the hospitals where they work.

When empowered as clinician leaders, the 163 nurses created quality improvement initiatives across different channels, including healthcare-associated infections, early mobility and patient fall prevention. Some of their accomplishments include decreasing patient falls by 50 percent, pressure ulcers by 40 percent and healthcare-acquired infections by 50 percent.

All nurses are leaders, whether they work in patient care, executive capacities or specialized nursing roles. Being a leader is about more than assigned duties; among other things, it requires critical thinking skills, a willingness to learn and supporting other nurses. The online RN to BSN program at California State University San Marcos can help students prepare for the challenges of the nation’s expanding healthcare system and contribute as nurse leaders at all levels.

Learn more about the CSUSM online RN to BSN program.


(2016, March 3). 20 million people have gained health insurance coverage because of the Affordable Care Act, new estimates show. U.S. Department of Health & Human Services

(2014, April 24). Nursing Shortage. American Association of Colleges of Nursing

(2011). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press

(2015, December 17).(n.d.). Registered Nurses. BLS Occupational Outlook Handbook

Wisniewski, L. (n.d.) All Nurses Are Leaders. Monster: Nursing Link

(n.d.). Find Your Path in Nursing. DiscoverNursing

(n.d.). Nurse Executive. DiscoverNursing

(2014, May 1). The Importance of Nurse Leadership: Increasing Nurses in the Boardroom. Campaign for Action

(n.d.). Informatics Nurse. DiscoverNursing

Sherman, R., & Pross, E. (2010, January). Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level. The Online Journal of Issues in Nursing

Aylett, K., (2015, April 14). Nurse-led innovations at 42 hospitals nationwide improve patient outcomes, save more than $28 million annually. PR Newswire

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