AACN Envisions Clinical Nurse Leader of the Future
Monday August 25, 2003
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Jean E. Bartels, RN, PhD, president-elect of the AACN, discusses the evolution of the clinical nurse leader role.
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To this end, the AACN embarked on defining and creating the role of the "clinical nurse leader" about six years ago, amid reports of an increasingly problem-ridden healthcare system that is anchored, in many ways, by nursing care. "We had a fair number of discussions with people to look at what was happening in the healthcare system from a nursing perspective," says Jean E. Bartels, RN, PhD, chairperson and professor of Nursing, School of Nursing, Georgia Southern University, Statesboro, GA, and AACN president-elect. "[That led us to realize] we really need to look at what roles are missing in the healthcare system that nurses routinely fill, but could fill better, and how we might create a practitioner who actually came closer to the mark - in terms of providing what the healthcare system needed."
Today's nurses face greater responsibility for patient outcomes and higher degrees of complexity in the healthcare system and technology. With these mounting pressures according to Bartels, AACN believes the system must begin preparing a different kind of nurse - one trained for clinical leadership who would remain in, and contribute to, the profession.
AACN arrived at its conclusions after reviewing reports from many groups, including the Institute of Medicine and American Association of Colleges of Medicine. "Then, we talked to a variety of nurses from public health through acute care, [as well as representatives from] credentialing and regulatory bodies in nursing," says Bartels.
Bartels, who is also a chairperson for the AACN task force on education and regulation (which is responsible for the development of the clinical nurse leader role), says that the clinical nurse leader is not a traditional administrative or managerial role, and it is not a clinical nurse specialist as it is defined today. Rather, the clinical nurse leader is a nurse who works as a manager of care, at the point of care - essentially, a bedside nurse. Bartels says that these nurses exist today, but are rare. They're the ones who take it upon themselves to design, implement, and evaluate patient care. "We envision that they would do that by coordinating, delegating, and supervising care that is provided by the healthcare team, which would include various levels of licensed nurses, technicians, and other healthcare professionals that work on behalf of the patient," Bartels says.
The shift in this school of thought is that these nurses would assume accountability for patient care outcomes. They would do this, AACN envisions, by applying more intense research-based information.
While it is likely that the clinical nurse leader will need more education than a baccalaureate degree, that has yet to be determined, Bartels says. AACN is holding an invitational conference for about 100 nursing schools interested in making the concept a reality on October 24, and 25, 2003, in Washington, DC. Each of the schools, Bartels says, is being asked to bring at least one practice partner, which could be a hospital or other employer.
"The goal is to identify what educational model and complementary practice models would best provide care for patients in all settings," Bartels says. "What we want to do is to test education and practice models and identify what best affects outcomes, then, hopefully move education in the same direction."
For now, Bartels says that nurses should "stay tuned. As we get more information, we will make it as public as we can - so we can engage as many people in the process as possible. The October conference is meant to help us develop our approach and process."
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