The health care field is growing increasingly complex, and many nurse leaders will soon retire. Primarily, the baby boomer generation in conjunction with the changing dynamics in the United States health care marketplace have congealed to place a heavy burden on care provider facilities attempting to maintain sufficient organizational leadership.
As result, many nurse administrators may experience apprehension over being thrust into leadership roles earlier in their careers than expected.  Despite this, the practitioners share a desire to contribute to the organization in a positive way by spearheading initiatives that produce improvements. Overall, new nurse leaders are optimistic, yet cautious, about possible future developments that they might deliver.
Core Competencies for Nurse Leaders
Nursing executives steer care provider organizations in the delivery of safe, efficient, and effective treatment outcomes. Working in a collaborative, multidisciplinary setting, administrators are significant influencers in the quality of patient care and the improvement of health among populations.
The American Organization of Nurse Executives (AONE) outlines Nurse Executive Competencies that establish best practices for contemporary nurse administrators. The framework builds on the 2004 Healthcare Leadership Alliance Model, which lays the foundation for leaders in health care.
The following four highlights give a brief overview of some of the AONE competencies.
1. Organizational Communication
Effective nurse leaders manage relationships by creating an air of trust in the workplace, keeping commitments with peers and charges, and establishing processes that ensure follow-up on professional commitments. They foster a work environment that promotes diversity in gender, age, race, and religion. Additionally, nurse executives ensure that practitioners are culturally competent.
Nurse leaders build relationships within their organizations by maintaining open two-way lines of communication. They also reinforce policies designed to improve organizational performance. Such mechanisms create ample opportunities for physicians and nurse practitioners to work together to meet organizational objectives.
2. Medical Body of Knowledge
Nurse leaders demonstrate knowledge of current nursing practices and their charges’ professional roles. They guide organizations in compliance with the rules and regulations set forth by state and federal regulatory agencies. This includes the State Nurse Practice Act, State Board of Nursing Regulations, federal labor laws, and internal organizational policies. These guidelines align organizational activities with mission-critical performance indicators and successful attainment of value-based payment models. When issues arise, nurse executives take advantage of such situations to deliver opportunities for improvement.
3. Foundations of Leadership
Part of the foundation of thinking-skills for nurse leaders encompasses addressing the ideas, beliefs, and opinions held by their charges. Furthermore, awareness of one’s own leadership style is important. For example, nurse leaders may favor transformational, cross-cultural, or any combination of styles. Their beliefs, skills, and experiences also contribute to how they make professional choices.
During their careers, nursing executives learn from their successes and failures. Along the way, they develop their executive tool kits drawing on the latest problem-solving and decision-making best practices. These high-level executives adapt and change along with organizational conditions.
4. Workplace Professional and Personal Accountability
Nurse leaders hold themselves and their charges accountable for mutually held professional responsibilities. Within the context of the nursing community, nurse leaders contribute to the advancement of their profession and relevant associations. They also encourage nurse practitioners to participate in health care associations. Ethics are another important factor related to professional and personal accountability. Finally, nurse leaders advocate for the population’s health interests, especially underserved groups.
The Practice Moving Forward
The widely recognized 2010 Institute of Medicine (IOM) report entitled “The Future of Nursing: Leading Change, Advancing Health” denotes several critical goals for the nursing profession.  As an example, the IOM recommends that nursing professionals practice to the full extent of their capabilities. Duly, the Institute of Medicine encourages nurses to pursue advanced education that caters to current practitioners, combining their experience and the latest medical innovations. The institute also recommends that practitioners partner with physicians in shaping the future of the United States health care system. In part, the IOM endorses the removal of restrictions on autonomous practice for nurse practitioners. They implore practitioners to make their voices heard in front of Congress to promote agendas such as Medicare expansion, practitioner authorization to perform admission assessments, and certification for home health services. Additionally, the Institute of Medicine supports similar compensation for advanced practice nurses who deliver services and treatments on par with physicians.
The American Association of Critical Care Nurses (AACN) has put out a call for nurse leaders in the United States to work closely with their charges by delivering more effective communication about leadership roles and responsibilities. To promote this trend, more mentors must step up and provide leadership to fledgling practitioners by instituting strong nursing professional development initiatives that will lead America’s health care system into the future.
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