ABSTRACT
Nursing leadership is about critical thinking, action and advocacy. It encompasses mentoring, coaching, supporting, rewarding and attracting other leaders at all levels (CNA, 2009). Nursing leadership also involves contributing to the translation of research into clinical practice and the dissemination of nursing knowledge. Nursing education must be at the forefront of the movement to apply evidence-based leadership development models within the faculty, as well as in the student education (Cleeter, 2011). However, many schools of nursing do not offer a comprehensive formalized faculty development program, and nurse educators have indicated a lack of formal leadership training and insufficient education or experience for their positions. This is of importance as the literature shows that academic leadership has been shown to affect faculty satisfaction and retention and promote healthy work environments (Siddique, 2011). Thus, issues arise when it comes to putting nurses as health leaders in an organization despite their expertise and experience in the field of health and medicine not just inside the hospital but also in the public health setting.
Nurse leaders play a crucial role in the nation’s goal of achieving health equity for all. As the largest healthcare profession, nurses have much to offer as leaders in the fight for health equity and nurse leaders must have a seat at the decision-making table. Despite this case, the voice of nurse leaders were often absent at the highest levels of strategic public health and national response. There are still issues questioning their abilities as leaders in the decision-making process and it is the time to show their full potential as leaders and change-makers toward advancing health equity for all determining if their leadership competencies and skills is adequate to have a seat at the table and if not, develop a strategy on how they will reach their potential as leaders and perform their function well. This could be done if a framework will be properly utilized in the study that is being developed.
Framework
Competency based framework ensures a systematic approach towards the development of competence in nursing practice and opportunities in nursing research, leadership and management (Maglaya et al., 2006). Knowledge base should be continuously evaluated to ensure to cope with the current technology advancement as well as skills requirement in the practice of the profession. While competency is basic in measuring the knowledge and capacities of our health professionals, there was an advent of need to move to a higher perspective.
In 2012, Registered Nurses’ Association of Ontario (RNAO) presented a framework in anticipation that it can be used by nurse executives and often be referenced in leadership studies. The RNAO’s Framework for Nurse Executive Leadership is a unique model that is designed to delineate, shape and strengthen the evolving role of the nurse executive leader in Ontario and beyond. This framework is designed to delineate, shape and strengthen the evolving role of the nurse executive leader in Ontario and beyond.
Figure 1. RNAOs Framework for Nurse Executive Leadership
In describing the key framework elements, the framework has as its central core the key drivers and impacts of the nurse executive role, that of client, nurse, organizational and societal outcomes. Such outcomes are impacted by roles and responsibilities of governance, leadership and practice of the nurse executive leader in the key leadership spheres of: strategic visioning, organizational decision making and practice innovation; quality care and client safety; collaboration; professional accountability and professional development. In each of these areas the nurse executive enacts specific competencies, utilizes best evidence based practices, and leverages with key facilitators to address and overcome environmental barriers.
With this framework, the RNAO has created a Best-Practice Guideline (BPG) for promoting a healthy work environment (RNAO, 2013). The Healthy Work Environments project has produced several other BPG’s such as developing and sustaining nursing leadership. This BPG outlines nursing leadership competencies including; demonstrating and modeling integrity and fairness, demonstrating care and respect and personal care for others, creating a sense of presence and accessibility, effective communication, managing conflict, building and promoting collaborative relationships, demonstrating passion and respect for the profession of nursing and demonstrating role competence.
Having had the opportunity to work in Primary Health Settings assuming different roles, and having been part of the different leadership courses, I have seen the leadership potentials of our PHNs and the need to enhance their leadership competencies. Improving the capacities of our nurse practitioners would facilitate the performance of our nurses to their full potentials. Thus the development of a PHNs Leadership Competency Framework/Model is something I would want to work on.