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Oregon Nurse Online Article [Nursing's Time to Lead] [08/01/15]

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Nursing’s Time to Lead

by Connie Miyao, RN, BSN, Nursing Practice Consultant

It is in times of crisis that true leaders emerge. Leaders who will navigate us through the rough times and bring us to a more sustainable and improved health care system. Leaders committed to care, knowledgeable about the relationship between cost and quality care, and most of all, be honest, ethical, and worthy of trust. With these criteria for leadership, it is easy to see how nurses are a perfect fit. Simply put, as nurses, it is our time to lead.

In nursing you will find an unwavering focus on caring, understanding of the cost-quality relationship, and a professional contingent that is consistently ranked among the most trusted in the country. We are innovative battlers and problem-solving wonders. Regardless of the obstacles put in front of us, we find creative ways to get over, through, and around the hurdles.

The health care system’s problems will be solved in pieces and each piece will require hard work, insight, and support from the entire health care community. Every member of that community must place their trust in nurses and enable nursing to lead because as the largest workforce in most hospitals, nursing is an undeniable force in making a difference. In a time of crisis, true leaders emerge. For a path to triumph, nurses should lead the way.

Currently hovering around 18 percent of the U.S. gross domestic product (GDP), health care spending is expected to account for 20 percent of GDP by 2020, significantly more than in other industrialized nations. The forecasts show costs rising to even more unsustainable levels. However, with the increases in cost, there is no sign that the quality of care will improve. Even today, with the highest costs among developed countries, the U.S. ranks 7th out of seven countries graded in quality care, according to The Commonwealth Fund’s news release on June 23, 2010, titled “U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives”.

The delivery of health care through treatments, procedures, pharmaceuticals, labor resources, and technology is not clearly aligned with the outcomes, incidents, or the costs that the system generates. In addition, administrative burdens abound, with nurses reporting spending an average of 30 to 60 minutes on administrative work for every hour of patient care provided, according to the 2005 Joint Commission report, “Health Care at the Crossroads: Strategies for Addressing the Evolving Nursing Crisis”. This burden is robbing us of the time we could be spending on patient care, as well as the freedom to think critically about how to improve the overall system. Operational excellence must be a part of any health care solution. We must ensure that the procedures, labor resources, and technologies available are used efficiently and effectively to help deliver care to the patients instead of adding more obstacles between nurses and the patient.

In 1856, Florence Nightingale returned from the Crimean War with the determination to introduce evidence-based health care. She was a truth-teller who made hard decisions. She was not only instrumental in leading health care delivery out of crisis, but in introducing a new way to deliver better care and achieve better outcomes.

Like Florence Nightingale did back then, nurses currently have the opportunity to step up and take the lead.

Nurses must be as proficient in communication skills as we are in clinical practice. We must be relentless in pursuing and fostering true collaboration. We must be committed partners in making policy, directing and evaluating clinical care, and leading organizational operations. Staffing must ensure the effective match between patient needs and nurse competencies. As nurse leaders, we must fully embrace the imperative of a healthy work environment, authentically live it, and engage others in its achievement.

These are important times and what we do today will set the path for the future. A health care system that delivers the best care at lower cost is not only possible, but necessary. Nurses must have a strong voice at the table and share the role we play, the expertise we bring, and the power that we wield, to unite the entire team for the common cause. As Nightingale showed, we can become the most respected leaders. In other words, it’s our time to lead. Again.

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