Clinical Nurse Leader: A View from Education

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Clinical Nurse Leader A View from Education

• Roberta K. Olson, PhD, RN
• Dean, College of Nursing
• South Dakota State University

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Objectives

• Describe changes needed in the competencies of
  the new nurse who is titled Clinical Nurse
  Leader (CNL).
• Describe possible scenarios of how the
  educational foundation needs to change to prepare
  the CNL with the most appropriate knowledge and
  skills.

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I. Differences from CNL and current
Baccalaureate Essentials

• A. Input from stakeholders that change is
  needed.
• 1. The CNL must be prepared for clinical
  leadership in all health care settings.
• 2. The CNL must be prepared to implement
  outcomes-based practice and quality improvement
  strategies.

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I. Differences cont.

• 3. The CNL will remain in and contribute to the
  profession, practicing at his or her full scope
  of education and ability.
• 4. The CNL will create and manage systems of
  care that will be responsive to the health care
  needs of society. (p. 3, CNL White Paper, May
  2003).

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II. Assumptions in preparing Clinical Nurse
Leaders.

• A. Practice is at the systems level
• B. Population-level care outcomes are the
  measure of quality practice.
• C. Practice guidelines are based on evidence.

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II. Assumptions cont.

• D. Client-centered practice is intra-and
  interdisciplinary.
• E. Information will maximize self-care and
  client decision-making.
• F. Nursing assessment is the basis for theory
  and knowledge development.

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II. Assumptions cont.

• G. Good fiscal stewardship is a condition of
  quality care.
• H. Social justice is an essential nursing value.

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II. Assumptions cont.

• I. Communication technology will facilitate the
  continuity and comprehensiveness of care.
• J. The CNL must assume guardianship for the
  nursing profession. (pp. 3-6, CNL White Paper,
  May 2003)

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III. Elements of the Role of CNL

• A. Clinician
• B. Outcomes Manager
• C. Client Advocate
• D. Educator

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III. Elements cont.

• E. Information manager
• F. Systems analyst/Risk anticipator
• G. Team Manager
• H. Member of a profession (p. 8-9, CNL White
  Paper, May 2003)

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IV. Curriculum Changes

• A. Requirements prior to nursing
• Leadership experiences
• ACT or SAT score at ___ level
• GPA ___ (higher than current requirements)
• Health Care experience, e.g., CNA
• Other

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IV. Curriculum Changes cont.

• B. Course content in the nursing major
• Deletion of ________
• Addition of _______

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IV. Curriculum Changes cont.

• C. Course sequence for the curriculum plan
• Move current course work in the major to
  pre-nursing schedule, i.e., pharmacology,
  pathophysiology
• Add/require summer internship
• Post graduate residency
• Academic credit for modules typically taught by
  the practice institution

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IV. Curriculum Changes cont.

• D. Delivery of content and clinical
• Restructure didactic content, e.g., block up
  front, web enhance, etc.
• Restructure clinical content, e.g., immersion
  blocks

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IV. Curriculum Changes cont.

• Goal
• Early synthesis of theory and clinical
  application
• Increase leadership experiences
• Decrease fragmentation of clinical experiences
• Other

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V. Summary

• How can we think creatively, but retain best
  practices?
• Are we willing to risk changes?
• What will we gain?

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Summary

• D. What will we lose?
• E. How can this be a win-win?

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Conclusion

• Questions for Educators
• What would you need to change in the current
  education model to prepare a Clinical Nurse
  Leader?
• How would you facilitate these changes?
• What issues and challenges would need to be
  addressed?
• What education model would you consider
  implementing?