Clinical Nurse Leader: A View from Practice

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The Clinical Nurse Leader
Partnerships for Quality Care
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Clinical Nurse LeaderA View from Practice

• Cathy Rick, RN CNAA FACHE
• Chief Nursing Officer
• Department of Veterans Affairs

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It has been said that bold and innovative action
is needed to ensure a long-term supply of
qualified, compassionate, enthusiastic, and
satisfied nurses for hospitals and the
communities they serve.
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Focus on the future

• Settings
• Roles
• Clinical and support roles
• Science
• Practice models
• Impact of information age
• Availability of staff
• Funding models

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At the top of every agenda for shaping a vision
for the US healthcare system is a challenge to
launch new patient care delivery models.
Invariably, these agendas redefine roles and beg
the question Who should do what, where, and how?
These questions need to be answered to sharpen
our focus on patient-centered efficient care.
For nursing to address these issues, we must
define roles with specified competencies.
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Practice evolves and advances through the review
and analyses of experience as a deliberate
strategysupported by organizational structure
design and bourne out of appropriate preparation.
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The Clinical Nurse Leader Journey

• Task Force on Education Regulation 2
• White Paper describing CNL in response to
  changing landscape of healthcare
• NOT a revision of Baccalaureate Essentials
• Education/Practice partnerships
• Pilots
• Evaluation
• Transformation

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The charge to the practice setting

• Call upon visionary trail-blazers
• Nurse Executive, Nurse managers, staff nurses,
  advanced practice nurses, nurse researchers
• Determine what it is weve been doing that is/is
  not supported by evidence the practiceoutcome
  formula
• Stay patient focused !!!
• Look to the horizon, learn from the sunset

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Toughest challenge role clarification

• Nurse manager
• Clinical nurse specialist
• Clinical nurse leader
• Staff nurse
• Support staff

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Differences make the difference

• All roles must support each other
• All roles are valuable
• Symbiotic practice partnerships
• Distinct complimentary differences
• Role blurring creates tension
• Role boundaries are not rigid

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So The Clinical Nurse Leader Role

• Hands-on clinical practice
• Care management/ coordination
• Beyond episodes of care population management
• Full partner on healthcare team

• Apply and test the evidence evaluate impact of
  nursing teams care
• System approach
• Advance nursing practice at the point of care
• Rely on CNS as consultant

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Nurse Manager

• Personnel management
• Selection
• Coaching mentoring
• Designing delivery models
• Resource management
• Strategic planning
• Connecting the dots asking the right
  questions

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The Clinical Nurse Leader
Partnerships for Quality Care