Professional Documents
Culture Documents
Meghan O’Neal
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When thinking about the leaders of the healthcare world, many times the first person to
come to mind is the doctor. For centuries the focus and ideal picture of a healthcare team begins
and ends with the physician. Yes, the doctor plays a very large role in the healthcare world.
However, what about the nurse? Where does the nurse stand in this healthcare world? This paper
will help to better define the professionalism in nursing practice regarding leadership.
The title of “nurse” encompasses a variety of roles that the common person may not even
realize. Often times the nurse is the shoulder to cry on, the maid, the cook, the cleaner, the
pharmacy, the priest, the one who wakes people up at night, and so much more. Unfortunately
the title of “leader” does not often fall into the laundry list of roles the nurse plays on a daily
basis. According to Blais (2016) “Professional nurses today assume leadership and management
responsibilities regardless of the activities in which they are involved. Although leadership and
management roles are different they are frequently intertwined” (p 170). Although the leadership
efforts may not be recognized by others the nurse continues to carry a leadership role, along with
The issue then falls into place when the nurse is not viewed in the same professional
manner as the other members of the healthcare team. In order to promote nurse professionalism
as a whole we must first establish the nurse as a leader. In the past nurses have been viewed as a
vital role in the healthcare team, just not the leader. Because some nurses have now stepped into
more managerial positions the leadership roles travel outside of the workplace and into the
community setting as well. Instead of nurses being strictly bedside participants where they may
only perform leadership roles in the patient care area, they are now able to be seen in a more
professional light as a manager. This type of role would bring leadership opportunities such as
In today’s healthcare world most of the leadership positions are held by individuals with
an extended education. For example, a Master’s degree in Nursing with a Master’s degree in
Business is very useful when it comes to the corporate world of the hospital atmosphere. These
nurses will not only have the science and nursing intelligence, but a well-rounded background in
the business side of the hospital which would include numbers and marketing and finance, just to
name a few. Other leadership positions may require a Bachelor’s of Science degree in Nursing.
These positions may include but are not limited to, House Supervisor, Clinical Preceptor, Unit
Manager, and shift supervisor. In addition to the education the experience also plays a large role
in these types of leadership positions. The years of experience that each nurse has worked also
contributes to the types of leadership positions that are available to her. In general these higher
authority positions are often times filled with nurses who have twenty or more years of
experience within the nursing field. In addition to the number of years most of these nurses also
have a variety of nursing experience and have developed nursing skills within many different
fields of specialty.
The options for leadership style vary from nurse to nurse as well. Following a study about
nursing students and their interactions with the instructors, Huda (2014) states
transformational leadership, leaders tend to increase awareness and interest of the team
member, and inspires subordinates to achieve their goal. Transformational leaders enable
their subordinates to take responsibility of leadership, and thus preparing a second line of
leadership. (p 28)
This form of leadership brought upon the best outcomes for these new nurses and it helped to
establish a sense of professionalism in the young nurses who were still learning about the
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healthcare field. This journal continues to discuss to the discouraging effects a more authoritative
approach to teaching had on the students. Instead of promoting professionalism and inspiring the
young minds of early nursing students, this type of leadership was making students uneasy and
afraid to discuss their thoughts and concerns with the instructor. Although the options are endless
when it comes to which type of leadership style is used during teaching moments, it is important
The pros of leadership in the nursing world are easier to point out thanks to the growth of
possibilities with a nursing degree. Effective leadership is defined by Blais (2016) as “a learned
process requiring an understanding of the needs and goals that motivate people, the knowledge to
apply leadership skills, and the interpersonal skills to influence others” (p. 176). This quote
correctly defines what is taught in nursing school. Students learn how to effective communicate
communication allows nurses to better understand and motivate their patients towards the same
goal of getting healthier. The application of skills is what the entire nursing school idea is
founded upon. Whether this application is of the physical skills learned with needles and tools or
if it is the application of ideas and knowledge regarding the disease process. Finally, the
interpersonal skills not only come from nursing school but they are also developed through
continuous interactions with a variety of patients. Nursing is all about influencing others, and
influencing others to make the right choices about their health. Nursing is a lot of teaching, and
repetitive motions. The pros of the development of leadership come from the fact that nursing
school is an ideal set up for the creation of professional leaders. Nursing school equips students
The cons of nursing leadership occur when one examines the daily floor interactions
between team members. Each patient in the hospital setting has a team of people working on
their behalf to better their health. Often time this team consists of the physician, physical therapy,
occupational therapy, speech therapy, respiratory therapy, nursing, care management, pharmacy,
dietary, and most importantly the patient himself. Although in some smaller hospital settings this
team may not meet all together to discuss the patient and their status, this team is still in
communication via electronic charting. In a larger hospital setting this team often meets at the
patient’s bedside to discuss care from all specialties as well as plans for the day and goals for the
future. The nurse should be a main part of this communication simply because she is the one who
is with the patient for the majority of his time spent in the hospital. This is where the con of
professionalism comes into play. Instead a rounding upon patients is completed by this team and
the nurse is busy taking care of her other patients. Often times there is no phone call made to the
nurse to ask for her opinions or ideas, instead there are orders put in the computer when the
physician leaves and the nurse is forced to piece together what the plan of care is for the day and
week. New labs or testing will pop up under new orders and the nurse may already know that the
patient has had these labs or tests. Now she has to call and interrupt the physicians planning on
other patients to say something that could have simply been discussed if she was involved in the
initial rounding process. The nurse knows many things about her patients that the other
healthcare team members fail to see simply because of the amount of time she spends with him.
These actions do not help promote professionalism and cause tension within the healthcare team.
Society plays a large role in how nurses are viewed in the professional world. Most
recently female leaders have been on the rise and the promotion of female leaders has also been
acknowledged by the American society. However, in the healthcare world nurses aren’t always
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viewed with the same respect as other female leaders perhaps on the business end of things.
Some parts of society still picture nursing as dress and hat wearing ladies who clean and change
bedding. Instead of realizing that nursing consists of men, women, young, and old. A prime
example of the societal view comes from the close examination of how operating room (OR)
nursing came about. The surgical field has been ran by the physician for centuries, and shows
like Greys Anatomy display the finest physicians working together within the operating room.
OR nursing is a relatively new specialty and still has much to expand upon. The duties of an OR
nurse are not as clear as a medical surgical nurse, whom is well aware of the skills and general
knowledge needed to take care of floor status patients. Moszczynski (2008) states
As the role of the professional OR nurse became clearly defined, so too it became clear
that society was beginning to hold all professionals accountable for their practice. As the
role of the professional OR nurse became clearly defined, it became apparent that society
was beginning to hold all professionals accountable for their practice. The litigious aspect
exempt. Writings provided OR nurses with examples of practice deficits and expected
After close observation throughout the years OR nursing has now become an established
specialty in the healthcare world. Before, society viewed OR nurses as ones who possibly stood
in the operating room to watch, or maybe clean the patient. Currently there are many registered
nurses that assist during surgeries and handle all of the surgical equipment. There is also a clear
distinction between surgical technicians and nurses in today’s operating room. The technician
does not handle any aspect of patient care and is more focused on the counting of supplies as
well as the setup of equipment and supplies. Whereas nurses will handle details associated with
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the patient, such as IV lines, catheters, intubation tubing and taping as well as extremity
monitoring.
Change has been relevant within the nursing world for quite some time now. The practice
of medicine is ever changing as new evidence is presented and new knowledge is applied. Nurses
as leaders has changed as evidence by the need for Nurse Practitioners (NP) in the healthcare
setting. Specifically primary care physician offices are focusing on their NPs because the NP has
the ability to practice on her own without physician guidance. For example if a physician wanted
to take a vacation his NP could manage and maintain his patients within his private practice
while he was gone without needing his consent and guidance regarding prescriptions or testing or
procedures. Often times these NPs will take some of the workload off of a physician within the
private practice setting so that the patients needing less attention and simply checkups can be
evaluated and assessed regularly by the NP rather than taking a spot on a busy schedule of a
physician.
On the contrary, leadership is prohibited rather than promoted when it comes to the
bedside nursing. The previous example of planning for patient care with a team of healthcare
members also goes along with this topic well. In addition to that example leadership prohibition
can be viewed in the bedside nursing area when it comes to the generation gap of nurses. Today,
there are nurses in the field that are in their sixties, fifties, even their seventies. In addition to this
generation of nurses there are also many nurses who are in their twenties, and even their early
twenties. The old phrase of “nurses eating their young” then comes into play when the generation
gap gets the best of the interaction. Instead of older, wiser nurses promoting leadership and
professionalism and growth into the new wave of younger nurses they are often discouraging and
unaccepting of new ideas and young minds. This is not the case in all areas or for all nurses,
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however it does continue to be a problem amongst new graduates and does prevent them from
When it comes to the inter-disciplinary and the intra-disciplinary needs of the healthcare
world the first thing that comes to mind is the quality of patient care being delivered. While
reading about the inter-disciplinary examples the quality of care to consumers is explained as a
delicate balance between the continuity of care and the decrease in medical errors. In addition to
these methods the decrease in hospitalizations in general as well as a decreased hospital stay play
a large role in the quality of care delivered to patients today (Blais, 2016, p 184). Quality care
can only be delivered when the patients respect the leadership value the nurse holds as the intra-
disciplinary herself. If the patient can listen to the nurse and her teachings and accept her
methods for care then there is no issue. The issue comes into play when the patient becomes non-
compliant or aggravated and then takes his frustration out on the nurse because she is his number
one care provider. This strains the leadership and professional role that every nurse strives to
achieve. As for the inter-disciplinary issues the nurse may face a power struggle within the team
if the other members are not viewing her as their equal. Otherwise, the issue with the inter-
disciplinary team may come from a suggestion the nurse may make for a change in plan of care
in hopes of trying to express her leadership and professional abilities, and in turn is discouraged
or not given a chance to really even explain herself without the response being a no.
The nursing field has come such a long way from the 1820s in which Florence
Nightingale walked around saving soldiers using antiseptic techniques, providing fresh air, and
using a candle for light. Currently the opportunities for nurses seem to be endless. Upon
graduation one may be overwhelmed with the possibilities that the nursing degree provides.
Before nursing was viewed as simply a bedside care type of role and today there are nurses who
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have not performed the typical bedside care in years and simply answer questions on the phone
or assist in an insurance company when it comes to billing and finance. In addition to these roles
nurses around the world are also now participating in leadership roles such as managers and
supervisors of other nurses, aides, and clerks. The nurse manager of a unit in the hospital may
not perform any patient care what so ever but she also deals with all patient complaints and
issues as well as staff complaints, scheduling, holidays, and much more. As a nurse in today’s
world I feel encouraged to continue my education, and education plays a large role in the job
market today for any field but especially within the medical field. Unfortunately after reading a
complete issue analysis about nursing as a profession I was quickly disheartened by the results.
reflecting on one’s own work and therefore enhancing professional values, the process of
evaluation and belief in one’s own practice and autonomy. Professional conduct includes
positive values for the nursing profession, personal initiative, self-confidence and a desire
for involvement. Professional training for nurses can last anything from one to four
years and is not always conducted at the tertiary level. Pearson et al. summed up the
findings of different approaches in nursing education, which showed that nurses with a
university degree achieve a higher level of autonomy in their work than nurses with
vocational college education or secondary level education. Graduate nurses were more
skilled in communicating, problem solving and passing their knowledge on to others than
the other two groups of nurses. While nurses with a vocational college degree are ready
to start working immediately in a clinical setting, nurses with a university degree function
Although I am continuing my education and receiving a BSN degree, I have been a nurse for a
year now with the secondary level college degree. These results may be accurate for some AND
nurses, however I find myself functioning at a high level within an intensive care unit. I have
been complimented on my ability to adapt to change and provide the difficult level of care that a
neonatal intensive care unit requires. I cannot help but feel slightly offended by these results
even though I understand that they do not apply to everybody. I think instead of focusing on
nursing based upon the degree one holds it should be more based upon her abilities and level of
care provided to patients. A nurse is a nurse is a nurse and even though some have a BSN degree
we all perform the same job if one is a bedside nurse. Unless one has their master’s degree I
don’t understand why there should be any discouraging words towards a BSN or an ADN. In my
opinion it is results like these that restrict nurses from becoming leaders and growing in the
professional world. If one does not feel empowered within their position she is not going to
perform at her best. Aside from the results, the beginning sentences regarding self-evaluation and
autonomy provide me with hope that the professional world is becoming more accepting of
nurses. These sentences also reiterate my idea that professionalism is not always learned in the
classroom setting and can be acquired with experience. I think nursing is an ever-changing field
and there is something new to learn each day; therefore, professionalism should be increasing
References
Huda, S. (2014). Autocratic leadership in nursing. I-Manager's Journal on Nursing, 4(3), 25-29.
com.proxy-fs.researchport.umd.edu/docview/1561477801?accountid=27669
Moszczynski, A. (2008). Societal change and OR nursing in the pages of the AORN journal,
doi:http://dx.doi.org.proxy-fs.researchport.umd.edu/10.1016/j.aorn.2008.07.005
Savic, B., & Kydd, A. (2011). Nursing knowledge as a response to societal needs: A framework
doi:http://dx.doi.org.proxy-fs.researchport.umd.edu/10.2478/v10152-011-0007-3