Future of nursing: Nursing leadership and frontline nurses

Year after year, nurses are ranked the most trusted profession. They are the eyes, ears, and voices of patients —advocating for them during their most vulnerable times. The future of nursing and nursing leadership is now. Nurse leaders and frontline nurses have the education and skillset to change healthcare forever and improve health and wellness one patient at a time. Nurse leaders and frontline nurses work among communities that need the most support. These communities include:

• Lower socioeconomic communities
• Disabled communities
• Marginalized communities such as the LGBTQI, minorities, veterans, and senior citizens 

Transforming leadership 

Good leaders influence others to complete and accomplish goals. Nurse leaders and frontline nurses are in the position to transform healthcare and be the leaders of the future of healthcare. A few facts:

• As of 2019, there are over three million RNs in the United States. 
• The nursing profession is projected to grow 7% from 2019 to 2029, the fastest of all occupations.
• By 2032, there will be a shortage of 122,000 physicians. 
• By 2030, there is a projected nursing shortage. 
• By 2030, 82 million baby boomers will be over the age of 65. 
• The average age of a nurse is 50.
• By 2030, it is projected that one million nurses will leave the profession. 
• Chronic diseases such as diabetes and hypertension are on the rise.
• People are living longer.
• Focus on preventative care is on the rise.

Nurses to play a stronger role in healthcare policy 

With these facts, there will be an increased need for nursing services and nursing innovation. Nurse leaders and frontline nurses will need to sit at the table where important decisions and policies are being made to make major healthcare reform contributions. 

To transform leadership, leaders must also encourage nurses, who express interest, to take an active role in participating in healthcare policy. They should be encouraged to participate in advocacy and policy reform. The American Association of Colleges of Nursing (AACN) and Nurses on Boards Coalition can help navigate this. The AACN advocates for:

• Nursing education
• Nursing research
• Nursing practices 

Nurse leaders and frontline nurses should also advocate for:

• Paid time off for lobby days
• Elected nurse representatives from every hospital and state
• Greater focus on law and lobbying 

A call to lead at every level of nursing 

With the rise of mastered-prepared and advanced practice registered nurses (APRNs), nurses lead in all aspects of healthcare. APRNs include:

• Nurse Practitioners 
• Clinical Nurse Specialists
• Certified Nurse-Midwives
• Certified Registered Nurse Anesthetist 

Currently, the AACN is calling for a highly educated and qualified nursing workforce. Through thorough research, AACN believes all nurses should obtain a bachelor's degree or higher. According to the AACN Fact Sheet, bachelor-prepared nurses:

• Make fewer medication errors
• Create better outcomes for patients 
• Record fewer deaths
• Provide safer and quality health 

The AACN is also calling for interested RNs to obtain their Masters in Nursing (MSN) and then obtain a research-focused degree (PhD) or practice-focused doctorate (Doctor of Nursing Practice or DNP). With a highly educated nursing workforce, nurses are unstoppable. They can:

• Provide the highest level of quality care
• Practice evidenced-based care
• Conduct research 
• Lead health systems
• Change policies and procedures
• Teach
• Revolutionize healthcare

Leadership in a collaborative environment 

Revolutionized healthcare can't happen without a collaborative environment. Just as the American Medical Association (AMA) advocates for their doctors, nurse leaders must band together to have a strong network to advocate for the nursing profession. 

Nurse leaders must work in collaboration with all stakeholders to secure the future of nursing and improve healthcare. These stakeholders include:

• Insurance companies
• Pharmaceutical companies  
• Hospitals
• Providers
• Mid-level providers
• Communicate health providers
• Ancillary staff
• Patients and their families

Leading diverse teams from different disciplines

Nurse leaders should implement diversity in leadership and on the frontline. Nurse leaders should lead diverse teams from different disciplines. They must be prepared for this role. Nurses leading diverse teams are essential for nursing growth and education. With diversity comes new and innovative ways to combat the challenges of healthcare. Challenges include:

• Healthcare literacy
• Changing policies
• Cost of healthcare
• Negative outcomes
• Preventative Care 
• Mental health  
• Diversity in nursing 

A more analytical approach to roles and responsibilities

The roles and responsibilities of nurse leaders are multidimensional. With a more analytical approach, nurse leaders can define clear roles and responsibilities needed to be effective leaders. Nurses should practice to their fullest extent-highlighting their scope of practice. 

A more analytical approach also means:

• Driving more data
• Collecting data
• Verifying data 

Data analytics leads to creating action plans that improve patient outcomes. It also predicts where improvements are needed in nursing education and practice. 

A new style of leadership: Frontline nurses

COVID-19 forever changed healthcare around the world. Frontlines nurses are faced with making difficult decisions every day. There are countless stories of nurses creating innovative ways to care for COVID-19 patients and saving lives. With this exposure, frontline nurses are positioned to create a new style of leadership. They can lead change by creating new and improved processes. 

New challenges of nursing during COVID-19 

There are new challenges of nursing during COVID-19. Frontline nurses must heighten awareness to keep communities protected from further exposure to COVID-19 and future unforeseen circumstances. Other new challenges include:

• Planning
• Preparation
• Reporting
• Ethics
• Organizing
• Leadership roles

Nurses are facing personal challenges too. The nursing profession is already deemed stressful and demanding. COVID-19 has further exposed these challenges. Nurses are reporting:

• Fear
• Burnout
• Anxiety
• Depression
• Post-traumatic stress syndrome (PTSD)

Self-care for nurses

Nurse leaders need to place more emphasis on self-care for nurses. Self-care is positively caring for oneself by improving your physical, mental, and spiritual self. Examples of self-care include:

• Exercising regularly
• Taking mental health days
• Finding spiritual connections
• Creating self-care routines such as regular bubble baths, massages, and meditation 
• Eating healthy 

There needs to be more improvement and focus on self-care for nurses. The American Nurses Association (ANA) added a fifth provision to their code of ethics highlighting the need for moral respect for oneself and patients. When nurses focus on self-care, it improves:

• Stress
• Compassion and empathy
• Quality of care

Greater say-so in patient care and safety protocol 

COVID-19 positioned frontline nurses to have a greater say-so in patient care and safety protocols. Frontline nurses can shape the future of healthcare by sharing experiences and innovations created during the pandemic. Frontline nurses are in the trenches, and with this direct exposure, they can be leaders in changing:

• Healthcare policies
• Procedures 
• Safety protocols 

How nursing education can better instill leadership skills

The goal of the nursing profession is to create a robust and highly-educated nurse force. Nurses should become leaders in nursing innovation and change healthcare by providing cost-efficient and quality care. Nursing education is a path to better instill these leadership skills. 

Nursing education can achieve this by creating competencies in:

• Leadership
• Health reform through policies 
• Evidence-based practice
• Teamwork and collaborations 
• Community health
• Preventative Care 

Despite being ranked the most trusted profession, nurses are undervalued and underutilized. Lack of transparency, top-down leadership, and working in silos have created leaders who make all healthcare decisions. 

To make massive healthcare changes, it must be grassroots — a call to lead on every level of nursing. Nurse leaders and frontline nurses need to include a diverse group of nurses. They need to collectively come together to play an active role in changing healthcare. This can be achieved through:

• Participating in healthcare policy by changing legislation and regulations 
• Nursing education
• Nursing innovation 
• Technology and product design
• Entrepreneurship