THE ROLE OF CLINICAL NURSE LEADERSAllison Peters, BSN, RN, CNORUniversity of Central Florida

ASSESSING THE NEED FOR CLINICAL NURSE LEADER

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)

FORCES FOR CHANGE 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

WHAT WAS DISCOVERED 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).

QUALIFICATIONS 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).

ASSUMPTIONSAACN defined ten assumptions associated with the CNL

role:1. Practice is at the Microsystems level2. Client care outcomes are the measure of quality practice3. Practice guidelines are based on evidence4. Client-centered practice is intra-and interdisciplinary5. Information will maximize self-care and client decision making6. Nursing assessment is the basis for theory and knowledge

development7. Good fiscal stewardship is a condition of quality care8. Social justice is an essential nursing value9. Communications technology will facilitate the continuity and

comprehensiveness of care10. The CNL must assume guardianship for the nursing profession

(AACN, 2007)

CHARACTERISTICS 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).

CONCLUSION 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)

REFERENCE American Association of Colleges of Nursing (AACN). (2007) White paper on the role of

the clinical nurse leader. Retrieved October 29, 2010 from: http://www.aacn.nche.edu/Publications/WhitePapers/ClinicalNurseLeader.htm

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), 753-763. Retrieved from CINAHL Plus with Full Text database.

Morgan, B. (2010). What are the characteristics of a leader?. Dynamics, 21(1), 17-19. 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), 623-628. 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.