Virginia Nurses Today - November 2014

www.VirginiaNurses.com Virginia Nurses Today November, December 2014, January 2015 Page 9
Campaign continued from page 1
at the IOM, urged public and private health care entities to recruit nurse leaders
and encouraged nurses to prepare themselves for leadership. Today, the Future of
Nursing: Campaign for Action – a joint initiative of RWJF and AARP – is putting
new emphasis on the report’s leadership recommendation – and nurses and their
employers in government and other sectors are responding.
In September, retired military nurse Linda Schwartz, DrPH, MSN, FAAN, was
confirmed to a high-ranking position at the U.S. Department of Veterans Affairs.
Last year, Marilyn Tavenner, MHA, BSN, RN, became the first nurse to assume
the helm of the Centers for Medicare & Medicaid Services, an $820 billion agency
that manages coverage for 100 million Americans. In 2011, Patricia Horoho, RN,
MSN, MS, became the first nurse appointed as Army surgeon general. And in 2009,
Mary Wakefield, PhD, RN, was named administrator of the Health Resources and
Services Agency, which oversees more than 100 programs and 3,000 grantees.
“We have more nurses in top government positions, and top leadership positions
in health care and in other industries as well,” said Melanie
Dreher, PhD, RN, FAAN, dean emeritus of the college of nursing at
Rush University and Rush University Medical Center. Dreher, in
fact, chairs the board of Catholic Health East Trinity Health, the
second-largest not-for-profit health care system in the United States
– an indicator of the progress nurses have made in recent decades,
she said. “You wouldn’t have seen a nurse in this position 20 years
ago.”
Angela Barron McBride, PhD, RN, FAAN, chair of the RWJF
Nurse Faculty Scholars program National Advisory Committee and
author of The Growth and Development of Nurse Leaders, agreed.
“We’ve made a lot of progress,” she said, rattling off the names of
numerous influential nurse leaders and noting that more than 130
hospital CEOs are nurses.
Raising Awareness
The IOM report played a major role in raising awareness about the need for
more nurse leaders and the critical role they can play in system change, McBride
said. Shirley Gibson, DNP, MSHA, RN, FACHE, president of the Virginia Nurses
Foundation and co-lead of the Virginia Action Coalition, agreed. Action Coalitions,
in place in all 50 states and the District of Columbia, are the driving force of the
Campaign for Action and are working to implement IOM recommendations on nurse
leadership and other issues. “The IOM report has provided a body of evidence
and credibility around the value that nurses bring as leaders,” she said. “Before
the report was released, making that case was an uphill battle. Now we have the
evidence we need to move forward.”
Changing cultural norms have also played a role in elevating the role of nurses,
McBride added. Today’s nurses are more likely to have “full careers” – with fewer
and shorter interruptions for caregiving and other reasons – and are better
positioned to advance up organizational ladders. Nurses are also working in more
interprofessional settings and, as a result, are better understood by other health
professionals and able to take advantage of more leadership opportunities. And
unlike the past, many of today’s senior nurses put a higher value on mentoring the
next generation of nurses, she said.
Young nurses, for their part, increasingly see themselves as future leaders,
McBride noted. “What you have now is a real understanding that entry into the
field is just the beginning of a career. Nurses now go on to earn higher degrees, and
there is more awareness that they are on a developmental trajectory.”
Jacquelyn Campbell, PhD, RN, FAAN, program director of the RWJF Nurse
Faculty Scholars program, agreed. “Things have definitely changed,” she said, “but
there is still an important need for mentors and current leaders to bring younger
nurses along.” And that is a key goal of the RWJF Nurse Faculty Scholars and other
programs designed to develop nurse leaders, including the RWJF Future of Nursing
Scholars program, New Careers in Nursing, and the RWJF Nursing and Health Policy
Collaborative at the University of New Mexico. Partners Investing in Nursing’s Future,
a partnership between RWJF and the Northwest Health Foundation, also supports
numerous programs dedicated to cultivating nurse leaders.
“The IOM report has
provided a body
of evidence and
credibility around
the value that nurses
bring as leaders,”
said Shirley Gibson,
Virginia Action
Coalition co-lead.
The Campaign for Action is working to cultivate more nurse leaders and
implement other IOM report recommendations. In November, it will announce
leadership training scholarships for emerging nurse leaders. Action Coalitions
are also are working to cultivate nurse leaders at the state and local levels. The
Virginia Action Coalition, for example, sponsored an event in 2011 recognizing
40 young nurse leaders in Virginia, and other Action Coalitions are taking steps
to develop emerging nurse leaders in their respective states.
Leading Change
Nurses, of course, have been leading change since the dawn of the profession.
Florence Nightingale founded modern-day nursing in the 19th century, ushering
in changes to health care and science that helped improve and save the lives
of untold millions. Clara Barton founded the American Red Cross; Margaret
Sanger pioneered the women’s health movement; and Mary Eliza Mahoney, the
first black nurse in the United States, co-founded an organization for minority
nurses.
More recent nurse leaders include Shirley Chater, PhD, BSN,
FAAN, who served as the commissioner of the Social Security
Administration during the Clinton administration, and Sheila
Burke, MPA, RN, FAAN, who ran former Senate Majority Leader
Bob Dole’s Senate office before becoming executive dean at the
John F. Kennedy School of Government at Harvard University.
Still, Dreher would like to see nurses advance more quickly
into powerful positions. Data measuring nurses’ movement into
leadership positions is not available. “There is no master list,”
McBride said. But broadly speaking, she said, nurse leaders
are still regarded as exceptions to the general rule that defines
nurses as “helpers, but not doers.”
Historically, nurses have not been included in most policy
debates and few were at the proverbial table when major
decisions about health care reform were being made in recent
years.
Even now, many say, little has changed. Tavenner, for example, was one of
only four nurses who made it on to Modern Healthcare’s list of the 100 most
influential people in health care this year, according to an article on NurseZone.
com. And only 6 percent of hospital boards include nurses, according to a
survey conducted in 2010 by the American Hospital Association.
Yet nursing is the largest and most trusted health care profession, and
nurses spend more time with patients than other providers and see patients in
their broader environments – in their communities and homes and with family
members, Dreher said. More nurse leaders are needed in all sectors to share
their unique insights into factors that affect health and health care and the best
ways to engage caregivers and loved ones in patient care. “No one understands
patients – the person part of the patient – the way nurses do,” she added.
Ultimately, though, the onus to become leaders is on nurses themselves,
Dreher said. “We have the talent and the knowledge to lead, and people are
waiting for us to take charge. Nobody is holding us back, but us.”
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