T HE ROLE OF CLINICAL NURSE LEADERS Allison Peters, BSN, RN, CNOR University of Central Florida

A SSESSING THE NEED FOR C LINICAL N URSE L EADER o Clinical Nurse Leader (CNL) is a relatively new role developed by the AACN (American Association of Colleges of Nursing o First new role to be added to nursing in over 35 years o Developed in response to unsafe care environment, gaps in communication, numerous handoffs and discipline vs. patient centered care. o (Tornabeni, 2006)

F ORCES FOR C HANGE A complex health care system mired in science and medical technology Health insurance companies increasing restrictions & decreasing patient’s access to health care Patient’s receiving assembly line fragmented care Nursing shortage & staff retention Increased demands & responsibilities on unit directors Poulin-Tabor, Quirk, Wilson, Orff, Gallant, Swan & Manchester, 2008

W HAT W AS D ISCOVERED Clinical Nurse Leaders evolving as a practice focused and collaborative with other disciplines CNL’s as colleagues and scholars; the ‘attending’ of staff nurses Responsible for patient driven, evidence based, outcome oriented nursing process. Not an ‘add on’ to management or a replacement for the Clinical Nurse Specialist Impacted not only patient outcomes but financial, educational and integral for staff satisfaction (Ott, Haddock, Fox, Shinn, Walters, Hardin, et al., 2009).

Q UALIFICATIONS Task force developed by AACN for academic and characteristic guidelines (Task Force on Education and Regulation for Professional Nursing Practice- TFER1) TFER1 conclusion RN’s need to be masters level education to lead and guide practice care at point of care Patient care delivery system redesigned to assure new skills and competencies are maximized (Tornabeni, 2006).

A SSUMPTIONS AACN defined ten assumptions associated with the CNL role: 1. Practice is at the Microsystems level 2. Client care outcomes are the measure of quality practice 3. Practice guidelines are based on evidence 4. Client-centered practice is intra-and interdisciplinary 5. Information will maximize self-care and client decision making 6. Nursing assessment is the basis for theory and knowledge development 7. Good fiscal stewardship is a condition of quality care 8. Social justice is an essential nursing value 9. Communications technology will facilitate the continuity and comprehensiveness of care 10. The CNL must assume guardianship for the nursing profession (AACN, 2007)

C HARACTERISTICS Committed to excellence Effective communicator Solutions oriented Continuity of care Spirit of inquiry Compassionate Passionate Visionary Team committed Professional pride Improvement of nursing image, role model, mentor and coach to staff, stop victim mentality and enhance professionalism. (Morgan, 2010).

C ONCLUSION Clinical Nurse Leader Role has a positive impact on the way nurses practice, patient’s lives and collaboration with other disciplines Critical success of CNL program factor in the confrontation of current and future nursing shortages. CNL will inspire faith, confidence, trust, collaboration and innovation Crucial in attracting and retaining nurses (Sherman, 2008)

R EFERENCE American Association of Colleges of Nursing (AACN). (2007) White paper on the role of the clinical nurse leader. Retrieved October 29, 2010 from: De Casterlé, B., Willemse, A., Verschueren, M., & Milisen, K. (2008). Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study. Journal of Nursing Management, 16 (6), Retrieved from CINAHL Plus with Full Text database. Morgan, B. (2010). What are the characteristics of a leader?. Dynamics, 21 (1), Retrieved from CINAHL Plus with Full Text database Ott, K., Haddock, K., Fox, S., Shinn, J., Walters, S., Hardin, J., et al. (2009). The Clinical Nurse Leader (SM): impact on practice outcomes in the Veterans Health Administration. Nursing Economic$, 27 (6), 363. Retrieved from CINAHL Plus with Full Text database. Poulin-Tabor, D., Quirk, R., Wilson, L., Orff, S., Gallant, P., Swan, N., et al. (2008). Pioneering a new role: the beginning, current practice and future of the Clinical Nurse Leader. Journal of Nursing Management, 16 (5), Retrieved from CINAHL Plus with Full Text database. Sherman, R. (2008). Factors influencing organizational participation in the CLINICAL NURSE LEADER project. Nursing Economic$, 26 (4), 236. Retrieved from CINAHL Plus with Full Text database. Tornabeni, J. (2006). Clinical nurse leader: evolution of a revolution. The evolution of a revolution in nursing. Journal of Nursing Administration, 36 (1), 3-6. Retrieved from CINAHL Plus with Full Text database.