APN (Advanced Practice Nurse) leaders in elderly care setting

With healthcare becoming the most essential thing in the US, the use APNs (Advanced Practice Nurses) is becoming even more significant. It is predicted that, by the 2014, about 32 million US citizens will manage to gain access to health insurance, which will be provided by a private insurer or other insurers like Medicaid and will not consider the conditions that are pre-existing (Trepanier, Duran and Lawson, 2013). The increasing number insured population in the US represents essential increase latent consumers that are seeking healthcare.
Considering that many elderly care settings are currently struggling with the flow of patients and long waiting times, healthcare organizations will be forced to adapt to new methods, which will enable them to meet demands of 33 million patients (Trepanier, Duran and Lawson, 2013). According to Anderson (2001), Advanced Practice Nurses and the implementation of their leadership skills will be the key to meeting the demands that comes with the increment number of patients. Advanced Practice Nursing has helped to reduce the rate at which people die in the US. Moving towards 21[st] century, America was surrounded by a new healthcare crisis, which surrounded how people died.
People died at an early stage in the 20[th] century, which means they did not enjoy the fruits of elderly care settings. Comparing 20[th] and 21[st] century, it is essential to note that, people are now living longer something that has created a phenomenon known as the “graying of America” (Anderson, 2001). Despite that, it is also evident that many Americans are currently living at their old age with illnesses that are chronic. The issue of caring for the terminally and chronically ill aging population is currently being increased by a shortage in Advanced Practice Nurses. Such a change results in erosion of healthcare providers` ability to respond to terminally and chronically ill not only on an individual scale but also on a wider scale.
Considering these issues, this paper tends to evaluate the leadership role of APNs and how it affects work environments. The paper will also provide information on how APN leadership influences better patient outcomes. The idea being generated in this paper provides concepts showing that Advanced Practice Nurses plays an essential role in meeting the needs of the increasing number of patients in the US.
Leadership role of APNs and its effect on work environments
According to Lukosius (2004), Advanced Practice Nursing (APN) and its leadership role represents future boundary for nursing practices as well as professional development. APN is considered as a way of viewing the world that will enable questioning of the current nursing practices, creating new nursing knowledge, and provide an improved delivery of healthcare services and nursing (Lukosius, 2004). Considering this concept, it is essential to note that, leadership in APNs will affect the working environment by influencing different working concepts. These include the following.
Implementation of skilled communication.
The new nursing knowledge, which will be accompanied by the leadership roles in APNs, is likely to affect the working environment by implementing skilled communication. Many policies have mandated that specialized knowledge as well as skilled nurses be integrated in different working environments. However, such integration can only be accomplished through frequent, respectful and skilled communication (Trepanier, Duran and Lawson, 2013).
Skilled communication includes more than delivery of information in one way stream. It requires a two way method whereby people are required not only to think, but also to decide together. Regarding this concept, leadership or of APNs is likely to implement a culture of excellence and safety, which will require all nurses to make the implementation of skilled communication a priority in development of all healthcare organizations (Trepanier, Duran and Lawson, 2013). This culture will enable civility as well as respect all nurses that speak from their authority and knowledge.
Lack of skilled communication is the reason why many patients currently in the care of clinical nurses suffer medical care errors at an alarming frequency (Trepanier, Duran and Lawson, 2013). More than three quarters of the errors in healthcare institutions are caused by human errors and are caused by human factors, which are associated with interrelations that are interpersonal (Trepanier, Duran and Lawson, 2013). Implementing skilled communication in a working environment will intimidate behavior as well as other interpersonal relationships, which in the past have lead to chronic distrust, mistrust and dissatisfaction among nurses.
Impact on collaboration
According to research, true collaboration is regarded not regarded as an event but a process. It is concept that needs time to build before it results to a working culture where decision making and joint communication between nurses become the norm (Villaire, 2005). Leadership role in APNs will likely affect this concept considering that APNs have the necessary knowledge to implement true collaboration. Differentiating it from the lip service given to collaboration, true collaboration has a unique knowledge as well as the ability of a professional to be respected in order to achieve safety and quality care for patients (Villaire, 2005).
APNs with a leadership role affects collaboration in a working environment since they have the knowledge required to impact trust, skilled communication, knowledge, mutual respect, shard responsibilities, optimism and coordination between employees. Study shows that, the lack of synchronous and outgoing healthcare collaborative work, patients` needs are harder to optimally be satisfied within today`s healthcare systems complexities (Villaire, 2005). Research has provided solid evidence showing that poor collaboration, which is mostly implemented on various measurable indicators not excluding patients satisfaction, safety and outcome staff satisfaction and retention, is the reason why healthcare in elderly care settings in the US is deteriorating (Villaire, 2005).
The leadership role of APNs is likely going to bring in an interprofessional cooperation, which in the past has lack thus creating a barrier to hospital safety (Villaire, 2005). More than 90% of nurses in the US reports that, collaboration with administrators, physicians and professionals is the most essential component and something that is required to create a work environment that is healthy (Villaire, 2005). However, while this concept is hard to implement, it is much easier with APNs with a leadership role in the picture. This will likely improve the mutual respect that exists between physicians and nurses because of each other`s knowledge as well as competence. It will also affect the mutual concern providing that quality patient care and the key organizational elements of working environment that mostly attracts and retain most nurses (Villaire, 2005).
Improve decision making abilities
Various hospital standards regard nurses as professionals who should be valued and seen as committed partners when it comes to the decision and policy making in different healthcare organizations. Although this concept is considered on paper, it has hardly been applied in reality. APNs with leadership roles will implement this concept considering their nature of knowledge and their role. Making decisions and especially those decisions that impact elderly care setting is essential, which means all nurses needs to be involved. There is a significant gap between what nurses are accounted for and their capability to participate in decisions, which are likely to affect their capabilities.
However, APNs have access to the knowledge with provides them with the required ways of bridging this gap. According to research, most physicians, administrators, pharmacists and even head nurses have the tendencies of appointing primary tasks regarding patient responsibilities to nurses (Villaire, 2005). However, as little as 8% of these professionals recognize nurses as an essential part of decision making team, a problem that can only be improved with APNs with leadership roles being implemented (Villaire, 2005). APNs with leadership role influence the power that is given to nurses thus enabling them to change various things they do not like in a working environment. By closing this gap, nurses will have the ability to optimize their important contributions as well as fulfill their responsibilities to the elderly care settings.
Impact decisions regarding staffing in an organization.
Most American elderly care settings are influenced by the choice of staff they implement. In fact, staffing that is inappropriate has been regarded as a threat to patients` safety as well as nurses well being. In many elderly care settings, nurses are required to work longer and inflexible working hours. This concept according to study deteriorates nurses ability to work effectively thus increasing the likelihood of many deaths in these settings. The inclusion of APNs with leadership roles in elderly care setting is essential considering the problems that most nurses undergo in these settings.
Other professionals like physicians and administrators lack the knowledge to understand what most nurses in these setting undergo. Considering that most nurses intercepts 86% of medical errors that are made by other professionals, it is likely that these errors will compound if nurses are overworked, stressed and are in short supply (Villaire, 2005). APNs with leadership roles understand this norm, and therefore, are likely to ensure the right number of nurses in an elderly care settings is implemented. Staffing is considered as a complex process as well as something that will require matching patient needs. Only APNs can understand this concept and in the process provide the required answers to most of the errors that administrators and other professionals do when they staff a particular elderly care setting.
The influence of leaders in better patient outcomes
According to Cummings (2011), leadership is considered as an obvious focus when it comes to addressing the outcome of patients. Clinical leadership has the ability to influence patients` outcome. All the issues, the warts, the failures and successes despite a considerable investment in resources can be influenced by clinical leaders. Leadership is something that exists in all healthcare systems from a front line to senior executives and even regional levels. The question, however, is how APN with leadership roles influences the patient outcomes. In most literature reviews, scholars have tried to examine the relationship that exists between leadership and patient outcomes.
In most of their reviews scholars have found that transformational leadership are more related to better patient outcomes when it comes to reduction of events that are adverse, mortality, complications and increasing satisfaction of patients. In elderly care settings, Nagel and Andenoro (2012) have provided arguments suggesting that, challenges that accompany the delivery of quality patient care is consistently considered as a major discussion topic in today`s complex and demanding healthcare industry. Healthcare in the current developed world is confusing as well as multifaceted than how it was previously.
In an array of characteristics, is will be difficult for even the person with the most knowledge to find distinctive relationships that can help to create a healing relationship for patients and families that lead to certain psychological reactions. However, there are three leadership traits that have been considered to be supportive of patient care processes (Nagel and Andenoro, 2012). These three traits are considered essential since they emerge as themes that are required to address the ability for APNs with a leadership abilities to garner the state of being create the foundation for practices that are grounded in dispositions and attitudes including presence, emotional care, and awareness and go beyond the domain of behaviors.
According to Hughes (2012), leaders influence patients outcome by influencing nurses activities, which provide healthcare to patients as well as, determine the safety of patients. Because of their knowledge, APNs with leadership role help nurses to apply their knowhow, experiences and skills, which are required to change patient needs. This takes effect because a larger part of patient care as well as their changing needs is taken care of by nurses. According to a survey conducted by Schwartz Center, which included 500 physicians and 800 patients, it was found that nurses even though they came second after physicians produced patient outcome that is significant compared to the outcome of physicians (Nagel and Andenoro, 2012). APNs with leadership roles according the research provided healthcare services that were delivered with compassion. Their influence was more noted because of their awareness and presence factors, which made a difference in the patient`s recovery from illness. Leadership in nursing also has the ability to make a significant difference in a critical situation.
Lack of nurse leaders in most case has left most healthcare organizations very critical since other professionals lack an idea on how to carryout nurse duties. The idea on employing a nurse leader according research enables a healthcare organization to mobilize its caregivers regardless of the roles they have been issued by the hospital. It brings about the ability create a proper working environment while proper flow of patient services ensures that all patients are part of a healing process. Clinical leaders also influences patient outcome by impacting on their emotions. Most nurse leaders understand the complexity of emotions. Defined as a system of interactions that involves physiological personal reactions, emotions can be very difficult to understand without the right knowledge.
Nurses with leadership capabilities are able to influence patients` emotions by understanding their emotional needs, which leads to a better patient outcome. In a situation that is stress-filled like a hospital, it is possible that a number of emotional reactions will emerge with wide ranging forces. When there is lack of leadership in such a situation, it is very possible that many patients will enter into the system that is not only stressed but one that has been based on anxiety and fear since they lack the slightest idea on what is actually taking place. These concepts make the presence of nurse leader an essential additional in a healthcare organization.
Anderson, C. (2001). Advanced Practice Nursing Meeting. ISBN.
Bryant-Lukosius, D. (2004). Advanced practice nursing roles: development, implementation and evaluation. NURSING AND HEALTH CARE MANAGEMENT AND POLICY.
Cummings, G. (2011). The Call for Leadership to Influence Patient Outcomes. Nursing Leadership, vol.24, iss.2, 22 – 25.
Hughes., R. G. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality.
Nagel, C., Andenoro, A. (2012). Healing leadership: the serving leader`s impact on patient outcomes in a clinical environment. Journal of Healthcare Leadership, vol.4, 25 – 31.