Nurse Leaders

3. Creatively Leading Change in an Inclusive Manner as a Core Competency for Nurse Leaders: Literature Review of Current Trends within Health Systems across the US

Leadership is non-hierarchical and is not restricted to specific skills or attributes. The availability of nurse leaders throughout the health care system is necessary for creatively leading change in the US healthcare system. Nurse leaders’ creative leadership is important in addressing the patient safety problems in the US health system. Nurse leaders require skills to engage other health professionals to address the prevailing problems in fragmented healthcare. All nurses require significant leadership competencies to effectively, advocate for and implement ongoing reforms in the healthcare system. They require being strong leaders to achieve the vision of a transformed health care.

The institute of medicine reported that an annual range of between forty four thousand and ninety eight thousand deaths occur due to medical errors. This statistic marked the beginning of recommendations for nurse leaders to participate in the development of better patient centered care and improved care environments. Nurse leaders play significant roles such as serving as a mentor, influencing the implication of the care environment on patient outcomes, nurse’s professional satisfaction, reducing their turnover rates, and fostering greater autonomy in their decision-making processes (Hyrkas & Dende, 2008).

Nurse leaders guide the process of care because they understand the interdependency of all the care disciplines and how to utilize the team’s expertise and intellectual capital. This creates efficiency in the healthcare system through limited communication gaps and minimal disruptions, delays and errors. The nurse leader effectively engages experts in other disciplines to deliver appropriate interventions. For instance, the nurse leader facilitates addressing of an issue such as a case manager offering effective interventions to solve length of stay associated problems. A nurse leader’s facilitation role requires strong competencies in clinical decision-making, communication and collaboration to achieve measurable health and system outcomes (Hyrkas & Dende, 2008).

Reform and transformation of the healthcare system requires that the nursing profession produce strong and capable leaders. It is important to develop nurse’s capacity for leadership and skills for enhanced collaboration with other health professionals. This development is necessary in enabling the contemporary advanced quality patient care (Porter-O’Grady, 2011). Nurse leaders require human resources development, which broadens their knowledge to include goals of the organization. This learning serves an important role in creating a positive professional empowerment to enhance emotional intelligence as an important ingredient of providing quality care. It also fosters a creative work environment, improves job satisfaction and impacts on retention (Hyrkas & Dende, 2008).

Nurses have the responsibility of developing and executing the needed change strategies for the purpose of improving the quality and access of patient centered care. Advocates of the concept recommend incorporation of leadership development in all levels of nursing education. Nursing education also requires practical exposure to programs directed towards improving healthcare (Porter-O’Grady, 2011).

Nurses also require taking personal steps to develop their professional growth. They must take personal initiative for individual education and explore opportunities to develop their leadership skills (Poulin-Tabor, et al., 2008). Nursing bodies also have a role in increasing opportunities such as mentoring programs and leadership development for nurses to exploit. Creatively leading change requires that nurse leaders have leadership capacities to network with all important stakeholders in healthcare. It is also important for them to assume the position of full partnership with other disciplines in healthcare decision-making (Porter-O’Grady, 2011).

Creatively leading change requires that nurses are also involved in development of health policy. It results in a pragmatic shift where nurses begin to view themselves as agents of policy driven change rather than mere recipients of the policy driven change. Nurses have greater involvement and control of health policy when their education entails studying political influences and managing complex multifocal relationships (Porter-O’Grady, 2011).

In creatively leading change, nurses require interacting with players such as physicians, patients and other healthcare professionals for interdependent and comprehensive decision making in health care. This is because one-dimensional solution is insufficient to address problems in healthcare. This implies that there is need for partnership-based leadership to significantly result in better health outcomes, decreased error rate and increased staff participation and satisfaction levels. When nurses work through effective professional partnerships, board membership and governance bodies indicate strong chances of successful alliance based policy (Porter-O’Grady, 2011).

Indeed, nurse leaders play a significant role in leading change in the US health system which is marred by fragmented care and its subsequent problems. They have important critical thinking skills that allow them to offer holistic patient care. Creatively leading care requires the nurse leader to forge partnerships with other health professionals. This is an a bid to address the fragmented type of care that results in negative health outcomes such as increased length of stay and staff dissatisfaction that results in high turnover. Nursing education require incorporating leadership development training in nursing curriculum. Nursing bodies also require creating opportunities for nurse to develop their leadership competencies through avenues such as mentorship programs. Nurses also have a responsibility for their personal and professional development to boost their competencies. This is because they require the competencies in their participation in driving policy aimed at bringing change to the fragmentation of care and addressing its subsequent problems.


Hyrkas, K., & Dende, D. (2008). Clinical Nursing Leadership-Perpectives on Current Topics. Journal of Nursing Management, 16, 495-498.

Porter-O’Grady, T. (2011). Leadership at All Levels. Nursing Management, 33-37.

Poulin-Tabor, D., Quirk, R. L., 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 Managemnt, 16, 623-628.