NurseWeek News

Lead by Example
Essence of nursing leadership comes from the collective voice of nurses

By Barbara Brown, Ed.D., RN, FAAN
August 12, 2002

More than 126,000 nursing positions are unfilled right now and the situation is worsening. In an urgent call to action, the Joint Commission on Accreditation of Healthcare Organizations assembled a panel of experts for a special news conference Aug. 7 to propose solutions to the nursing shortage.

Patient care is suffering from a dramatic shortage of nurses, who are the frontline of care and support for patients at the most vulnerable points in their lives, according to the JCAHO. Recent studies reveal that having too few nurses results in increased patient deaths, complications and other undesirable patient care outcomes. Evidence-based practice studies show that fewer nurses leads to increased length of hospital stays, patient falls, medication errors, more patients returning to acute care because of posthospitalization complications, and lack of time to teach patients how to manage their health problems, to name a few.
Baby boomer nurses are aging and faculty in schools of nursing are retiring, with limited new educators who are prepared to teach available for replacement. We have unprecedented demands on our country's health care system and resources are diminishing along with the quality of care. Consumers are advised to take a family member or friend to the hospital as a patient advocate, and we are questioning why and what has happened to the profession of nursing.

I recently returned from University Medical Center in Tucson, Ariz., where there is a commitment to a staffing ratio of no more than four patients to one nurse. The many units I visited were busy and nurses seemed positive about their work environment because they were supported by the administration and believed that they made a difference in the outcome of their patients.

Data relating to patient outcomes at the medical center will be available in the spring, as will data from the University of Colorado Hospital, where I also recently visited. Will data about patients really make a difference to those who control the finances and politics of our work environments? I am doubtful. What we need is strong nursing leadership that will advocate for every practicing nurse to enable the best professional practice environments, where nurses leave their work each day feeling good about how they practiced and made a difference for their patients.

The sense of pride in being a nurse was clear in both these practice environments. At the University of Colorado Hospital, a huge banner was hung on the outside of the building proclaiming its Magnet status for nursing care-a hallmark of excellence for all to see. I would think the original Magnet studies would have been a clear indication to all nursing leaders as to what needed to be done to avert this shortage.

What is wrong with us that we have to reach the depths of despair in our profession and only a few leaders have consistently risen to the cause for nursing and patient care advocacy? I think others have led us too long. The real essence of strong nursing leadership comes from the collective voice of nurses. Listen to what is best for nursing practice and then patient care will be the best.

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