Nursing Leadership

Good leadership is very essential in the efficiency and success of any hierarchal operation. Clinics and hospitals also adhere to this kind of top-down management in dealing with their affairs. Strong leadership should be observed in this kind of field since it deals with the well-being and lives of people. That being the case, there is a continuous effort to improve the performance of the people involved in this work.

The establishment of clinical nurse leaders (CNLs) is one of the new methods utilized in order to enhance the nursing services in clinics today. CNLs have the main responsibility of helping with the tasks of bedside nurses by means of giving care coordination and assistance for patients that needs more attention. The Association of Colleges of Nursing (AACN) has already certified this role of the CNLs.

Before a nurse could be considered for the position of CNLs, a complete masteral program is required. The necessary program for this position would focus on clinical as well as organizational skills. In order to develop these aforementioned qualities, there would be a series of trainings in key areas like "risk assessment, quality improvement, implementation of evidence-based practice, lateral integration of care, and inter-professional communication skills" (Meyers, n.d.).

The presence of CNLs is believed to improve the standard of care for every patient. This is based on the idea that bedside nurses have too much tasks at hand that most of the time they no longer take into consideration the broader perspective of the nursing situation. This exact problem is answered by the CNLs as their tasks include thoroughly understanding the condition of the patient through a detailed interview of patient and its family. Their services also include assessing the plan of care of the patient as well as creating a plan for discharge and adjustments in care plans if needed. Evaluation is also conducted on the outcomes of each patient in order to measure cohort risk. Moreover, they also practice "evidence-based practice" so that they could attend to their patients with the most recent information and innovation concerning their health care (Meyers, n.d.).

The leadership role of the CNLs is also observable as they also take charge whenever there are gaps in the shifting of the nurses, and they are also recognized as the leader in the floor. Mentoring and coaching are also included in the description of their job as they could train their staff in order to prevent problems or deal with it accordingly while it is happening. This is important since 70 percent of new employees are fresh graduates who need to enhance their critical thinking because they are adept with task-oriented skill. Moreover, bedside nurses are more confident and comfortable knowing that they have their CNLs to come to their aid whenever it is needed.

There have been favourable results in the implementation of CNLs like the one experienced by the Miami Valley Hospital in Dayton, Ohio. The medical/surgical unit of the hospital has improved as they are now more focused in giving cooperative effort to enhance the outcomes of patient care as well as improving the work environment (Meyer, n.d.). That being the case, I also planned to use this kind of operation to my unit. I work on a medical/surgical unit with 36 beds and I intend to analyse the effects of implementing the CNLs in my unit.

Based on the ideal management style, a superior should have a maximum of six subordinates in order to effectively perform his or her duties as a leader. Since there are 36 beds in my unit, I will make sure that the bedside nurses that are taking shifts to give the necessary attention to those patients would be under the supervision of CNLs. The ratio would be one CNL is to six bedside nurses. In doing so, every CNL could focus in the development of every nurse.

Having CNLs in our surgical unit would be very beneficial since most of our bedside nurses still lack the necessary skill when it comes to dealing with problem-solving processes especially since they are not well-equipped in handling issues that are not under their specified tasks. The necessary supervision is also another problem in our unit, which could be substantially solved by having CNLs. If there is one leader in every six nurses, then it would be easier to assess and review the performance of our bedside nurses. Moreover, it would also be advantageous to create teams that could better facilitate cooperation within the unit. Every team would be composed of six bedside nurses and one CNL. The CNLs would then coordinate among each other the concerns and issues of their members as well as their overall assessment of the performance of the whole unit and related issues like their working environment.

However, there are also some things that need to be considered before employing the CNLs in the unit. The most notable is the additional cost that comes with the designation of CNLs. Since these leaders have to undergo the necessary programs and rigorous trainings in order to qualify to the necessary standard for this position, this would mean additional budget in order to provide for these required programs. Moreover, if the clinic would hire a certified CNL who had already undergone the needed program and training, there is still a need for more funds because the salary required for the services rendered would be higher than those of the usual bedside nurses.

Taking all things into consideration, I deem that having CNLs in the surgical unit would be very beneficial for the clinic. This could foster better working condition in terms of training, motivating, and assessing the bedside nurses. Having CNLs would also enhance the cooperation among the nurses as well as making sure that they are focus in their job. The benefits that could be gain from this would mostly be for the well-being of the patients, which is the most important factor in the medical field. Lastly, it is quite reasonable to conclude that the added cost is worth the improvements, which could be gain in having CNLs.


Meyers, S. (n.d.). CNLs Proving Useful on Nursing Floors. Med/Surg Specialty Guide.

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