Want To Improve Health Care? Let Nurses Take the Lead

Spend even a little time at a hospital, clinic, or care center, and you'll notice something: nurses make health care happen.

It's nurses who deliver the majority of hands-on care. When patients are fearful, in pain, or uncertain, they look to nurses for guidance. Other health care professionals take their cues from nurses, too. When a new doctor is learning to practice medicine, nurses play a huge role in showing her the ropes.

Nurses are natural leaders. But when it comes to leadership at the highest levels, nurses are thin on the ground. In 2011, an American Hospital Association survey found that nurses hold only 6 percent of seats on hospital boards. So when decisions are being made about budgets, strategy, and policy, there usually isn't input from those who understand patient needs best.

Nurses need to step up and lead

Nurses are the face, the heart, and the hands of health care. It's time for us to be the voice, too. At nearly 3 million strong, nurses make up the largest part of the U.S. health care workforce. And because we're in the trenches every day, we have the best view of what works, what doesn't, and what needs to change. To help make health care work better for everyone, nurses have to take the lead.

The first step is education. About half of nurses have an associate's degree or nursing diploma. The other half enter the field with bachelor's degrees. In a landmark 2010 report, the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation called for increasing the number of bachelor's-prepared nurses to 80% by 2020. Many public-and private-sector organizations joined in. The U.S. Army, Navy, and Air Force now require a bachelor's degree for nurses seeking promotion. Starting in 2013, nurse managers and nurse leaders must hold bachelor's or graduate nursing degrees in order for their hospitals to earn Magnet status, the gold standard for excellence in nursing and patient outcomes.

Better nurse education, better patient results

When nurses are better prepared to take the lead, health care improves. Researchers have concluded that higher education rates among nurses are directly related to patient outcomes. One report found that a 10% increase in the proportion of nurses with BSN degrees decreased the risk of patient death by 4%. It's not an exaggeration to say that nurse education is a matter of life and death.

Building the skills to lead

To develop their leadership potential, nurses will need new ways to grow as leaders. Professional associations, universities, and other education providers are stepping in to meet the need. Here's how:

• Leadership skills training. This fall the American Nurses Association (ANA) is introducing the ANA Leadership Institute to empower the leader within every nurse. The Institute's first initiative is a series of interactive webinars, powered by Capella University, to help nurses build their skills in strategic thinking, leading people, and leading for results.

• Online learning. For any working professional, it's difficult to find room for school. But for nurses, whose schedules run around the clock, it's even harder. Online learning programs allow nurses to fit school around their shifts, rather than the other way around.

• RN-to-BSN and RN-to-MSN programs. Forward-thinking nursing schools have seen the need to help RNs build advanced skills quickly and efficiently. RN-to-BSN and RN-to-MSN programs help RNs maximize their educational investment, develop advanced nursing skills, and progress to a Bachelor's or Master of Science in Nursing.

• Professional doctorates. For high-level nurse leaders and nursing faculty, the Doctor of Nursing Practice is quickly becoming a sought after credential. With a focus on applied research, this doctoral option allows nurses to develop sophisticated research skills that they can use to make a real, measurable impact on patient care. The IOM report on the future of nursing calls for doubling the number of nurses with a doctorate. A greater number of DNPs and PhDs in nursing is needed to meet the complex needs of patients and to educate the next generation of nurses.

Great opportunity, great responsibility

In the coming decades, nursing jobs are expected to grow at a rapid pace. At the same time, the profession grows more complex every day. An aging and increasingly diverse society, increased rates of chronic illness, a health care system that has become a political battle ground--all of these factors make nursing more challenging than ever.

Meeting these challenges is going to take leadership from each and every nurse. Not everyone will lead teams, head up hospitals, or create policy. But every nurse will have to become a leader in health promotion, education, and treatment. Every nurse will have to take responsibility for developing the confidence and competence to lead. Every nurse will have to find her voice.