Implementing the Clinical Nurse Leader Role in the Women's and Children's Department Research Paper

Pages: 16 (4307 words)  ·  Style: APA  ·  Bibliography Sources: 1  ·  Level: College Senior  ·  Topic: Health - Nursing

Clinical Nurse Leader Role

Implementing the Clinical Nurse Leader Role in the Women's and Children's Department

The recently emerging role of Clinical Nurse Leader has come under extreme scrutinty by both the promoters of the position and the detractors. Developed as a further educational and training program to Clinical Nurse Specialist, Clinical Nurse Leader has the fundamental duty of coordinating the various components and personnel in a department. These duties will be analyzed in relation to the Women and Children's departments in hospitals.

Prevalence in Nursing

Theoretical/Conceptual Underpinnings

Project Description

Project Components

Community Contributions

Implementing the Clinical Nurse Leader Role in the Women's and Children's Department

Introduction

The recently emerging role of Clinical Nurse Leader has come under extreme scrutinty by both the promoters of the position and the detractors. The American Association of Colleges of Nurses (AACN) have created this new role in nursing as a natural progression of the changing roles and the diverse challenges that are confronting the medical profession in the new millennium in essence this new position was developed as further extension of an educational and training program to Clinical Nurse Specialist, Clinical Nurse Leader has the fundamental duty of coordinating the various components and personnel in a department. The Clinical Nurse Leader supervises the delivery of nursing care provided by professional and support nursing staff on any designated unit. This position ensure that care is provided in a manner consistent both with the medical profession ethically and professionally, as well as establishing clear guidelines in represented by the particular hospital or institution code of ethics. (Staff Nurses, 2007) These duties will be analyzed in relation to the Women and Children's departments in hospitals.

While a charge nurse has the responsibility to supervise primarily the nursing staff and other supporting staff, the Clinical Nurse Leader has the added responsibility of analyzing the other professional staff members involved on the floor, doctors, anesthesiologists, etc. To validate their performance and behavior is within the guidelines previously specified. While this position is not directly 9in charge of these professional, it is responsible to assure that the care being given on all levels is not only appropriate and consistent with good medical attention, but that it also meets the ethical and moral guidelines of the hospital and the medial profession at large.

These are critical feature in all departments, but ther are of an extreme concern in the various departments of women and children's care such as OB/GYN Emergency Room and Triage area, Labor & Delivery Suites, Labor & Delivery Recovery, Antepartum, Postpartum (Mother Baby), Several Newborn Intensive Care Units (NICU), and Gynecology Oncology. The Clinical Nurse Leader will be analyzed in general and then how it specially applies to the Women and Children's departments.

Purpose of the Study

There have been significant changes in the medical profession over the past decade. Aside from the many technological advancements there has also been a need to curtail medical costs in light of the current healthcare crisis and to also supplement the lack of doctors and other skilled staff that is becoming a concern. The creation and adoption of the position of Clinical Nurse leader is a necessary role to help to fill some of the gaps in the higher skilled care, while still maintain and perhaps even improving upon the level and consistency of care that is necessary in the are of Women and Children's department in hospitals.

The American Association of Colleges of Nurses (AACN) that have the potential to significantly change nursing education and practice from master's degree to the doctor's degree. The AACN proposed the development of a new nursing role, that is, the clinical nurse leader (CNL), in 2003. A CNL will require a master's degree in nursing and will have to design, implement and evaluate client care by coordinating, delegating and supervising the care provided by the health care team, including licensed nurses, technicians and other health professionals. Some nursing leaders and organizations have embraced it, but others have questioned its validity and usefulness. (Nelson, 2005, 24)

Significance of the Problem

While there is an increasing need for supervisory care in the nursing profession, there is an ever-present need in Women and Children's departments for consistency of care.

In a study entitled, a Controlled Trial of Nurse Practitioners in Neonatal Intensive Care, preformed in 1996, even then the authors already cite two prevalent factors that are contributing to the need there as well as in other departments of these units that contribute to the increasing need of Clinical Nurse Leaders as well as other supervisory staff:

The first is the reduction in the availability of pediatric residents, and the second is the increasing survival rate of smaller, sicker infants. These factors will not change in the foreseeable future; if anything, resident shortages will increase, as will the technological capacity to treat tiny, critically ill infants. Therefore, our study is highly relevant to current problems in the delivery of neonatal intensive care. Health care planners can now move forward confident that the process of care, parent satisfaction, and patient outcomes will be comparable with those achieved with current mechanisms of neonatal health care delivery. (Mitchell-DiCenso & Guyatt, 1996, p. 1143)

This need was initially halted by the lack of Medicare reimbursement for these positions, but recently the guidelines have been reviewed and Clinical Nurse Leaders as well as other staff are now under the Medicare reimbursement umbrella in most states. (Lego, 1998) Given the fact that most hospitals have been forced to cut down on staff, it make sense to attempt to incorporate some of these duties into one single position responsible the maintaining a standard level of care for the hospital and these departments. These cuts have hit hospitals throughout the nation, none have been spared the need to curtail budgets and have been forced to work with less qualified staff coming on board.

Prevalence in Nursing

Currently this position is gaining more interest in both the medical profession as wel as the administrative side of the spectrum. Proving itself both to be clinically advantageous and cost effective at the same time.

Perhaps we are watching the start of an evolution. An iterative process that is bringing the pendulum of masters-level nursing back to the center. National movements are calling for the development of a generalist masters-prepared nurse, the Clinical Nurse Leader degree (AACN, 2003). Discussions of a nursing practice doctorate are increasingly gaining favor (AACN, 2004). The blurred line may be the start of the movement towards expanding the impact of nurses on the total health of individuals. But before we get there, I still need us to talk about where the line is. (Mccabe, 2005, p. 88)

The line that Mccabe is referring to is that between the practice of nursing and the new clinical supervisory element that is being added to this position. Clearly there are still positions and roles to be ironed out but clearly this is becoming a more predominant need in the nursing as well as the medial profession as a whole.

For instance, one of the most difficult supervisory items that a floor charge nurse must do is attempt to schedule and distribute the workload of the floor properly. This has many variables and is also often a political mission as well as a strategic organizational mission. The charge nurse on the floor of the unit is often placed in difficult positions, having to decide not only how to distribute the workload, but to whom, and who was the most qualified as well as who may need to take on more responsibility. This particular supervision always is an attempt to balance education of staff with the proper allocation of the workload. She must also try and maintain a fair balance as perceived by the LPN's as to their assigned duties and amount of work they are given so as not to appear to be favoring or ignoring anyone. A good supervisor takes into account not only the needs of the patients, but the needs of those they are supervising as well.

Theoretical/Conceptual Underpinnings

It is important to realize the nursing, as in all medical related profession, continues to expand and grow both with the scientific and technical advances as well as having a need to adapt, change and grow along with the current cultural and economic environment. Nurse practitioner have now become commonplace and no longer treated as a perhaps second rate level of care. They have filled an important gap, that same gap is appearing in hospitals and in particular in the departments of Women and Children's units.

A in light of the expanding role of professional nurses in health care settings today, it is imperative that they acquire the leadership skills necessary to influence positively this dynamic and uncertain environment. These skills are vital for them to make an impact, considering the powerful relationship between leadership strength and influence. One characteristic of effective leaders is attainment of for- mal preparation and educational credentials in addition to… [END OF PREVIEW]

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