Please respond to the discussion and respond to the peer discussions

DQ1

Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community.

DQ2

Identify advocacy strategies that you can use to create change in your current workplace.

Peer discussion 1

To obtain your CNL you first must have your master’s in nursing and then take a certification exam hosted by the AACN. Currently what is happening in the career field of nursing is that there is a mixed reception with the CNL position. This is primarily do because there is a lack of understanding of how to transfer the role and its purpose into practice. Stated in an article by Heather Monaghan (2011) states, “CNLs provide education to all the different professional groups they work with as they integrate evidence-based practice and change at the point of care”. So, while in the hospital it is their job and role to help organize a plan of care. They delegate and work along since clinical nurse educators as well as staff nurses to help adjust based on evidence-based practice to patient care.

In their Transforming Practice, Transforming Care™ model for the clinician at the point of care, Monaghan and Swihart identified six elements of the CNL role, all of which are inter-related and need to be mastered:

Leadership and change, Interdisciplinary relationship, Knowledge transfer, Outcomes management, Clinician at the point of care, and Professional development.

Based on these roles CNLs work with a cohort of patients to help provide care, even though it may not be directly hands on care while in the hospital setting. Whether it be in the hospital or in the community CNLs are a co-coordinator of care and will use these strategies as well as their knowledge and access to the latest evidence-based practice to influence patient care outcomes.

Reference:

Monaghan, H. M. (2011). Clarifying the clinical nurse leader role: Guardian of care. American Nurses Today, 6(4).

Peer discussion 2

The American Association of Colleges of nursing (ANC) developed the Clinical Nurse Leader role in 2007. “The AACN (2007) emphasized the CNL role addresses the call for changes that are necessary for the country to address challenges faced in health care” (Sotomayer & Rankin, 2017, p. 2). Organizations, universities and hospitals quickly began to utilize CNL’s in their practices. A CNL acts as a navigator to high risk patients, coach and mentor to all. (Sotomayer & Rankin, 2017). The role of the CNL is still being developed but holds great promise to the practice of nursing in the upcoming years (Sotomayer & Rankin, 2017). A Master’s degree is required to sit for CNL certification. “CNLs oversee care coordination, provide direct patient care in complex situations, put evidence-based practice into action, ensure patients benefit from the latest innovations in care delivery, evaluate patient outcomes and assesses cohort risk and have the decision-making authority to change care plans when necessary.” (AACN, 2018, P.1).

Lorraine Kaack is a CNL. She paints a direct picture of her role through this quote, “The CNL does not have rotating patients on an 8-hour rotating basis, and the unique difference is that the CNL is assigned a particular cohort of patients that do not change from day to day. In doing so, the CNL has the ability to be mindful of those subtle changes that may go unnoticed by the staff nurse scheduling changes” (Kaack,2018, p.1). This means the CNL is a very important member of a patient’s healthcare team. The CNL’s role is consistent whereas a registered nurses role is everchanging. A CNL is like an investigator in they are trained to pick up what others may inadvertently miss. Nevertheless, the CNL is an asset to the practice of nursing and the CNL is a role that is being devised to improve healthcare and nursing practices across America.

American Association of Colleges of Nursing. Clinical Nurse Leader. (2018). Retrieved from: https://www.aacnnursing.org/CNL-Certification

Sotomayer, G.., & Rankin, V. (2017). Clinical Nurse Leaders: Fulfilling the Promise of the Role. Retrieved from: http://eds.b.ebscohost.com.lopes.idm.oclc.org/ehos…

Lorraine Kaack, MS, RN-BC, CNL . Retrieved from: https://www.aacnnursing.org/CNL-Certification/CNL-…

Peer discussion 3

Mistakes are inevitable as we are all human and humans make mistakes. When working with patients, mistakes can cost someone their life and, in an effort, to help build a safer health system the position of clinical nurse leader was developed to help address some of these concerns.

In order to become a clinical nurse leader, you have to have a master’s degree in nursing because you will have a higher level of clinical competence and knowledge that you can bring to the position (Graduatenursingedu. 2018). The CNL position is a certification that requires a minimum of 400 clinical hours within the CNL education program and 300 clinical immersion hours which can be included in the 400 total hours needed (Graduatenursingedu. 2018).

The clinical nurse leader plays an important role and has a great impact on direct patient care. Their position requires them to work in the clinical setting and within their scope of practice they facilitate collaborative care for patients, provide mentoring for staff, oversee a healthy working environment, collect patient risk, outcomes and care plans, coordinate direct care activities among nursing staff and provide lateral integration of healthcare services (Graduatenursingedu. 2018). All of these roles help improve patient care and ensure each and every patient is cared for properly with the highest level of safety and care.

Graduatenursingedu. (2018). Clinical Nurse Leader (CNL) Job Description. Retrieved from: https://www.graduatenursingedu.org/clinical-nurse-…

Discussion 4

The American Association of Colleges of Nursing (AACN) white paper in 2007 proposed a new role in nursing: Clinical Nurse Leader (CNL) to improve the health care outcomes (Sotomayor, 2017). The aim of the CNL is to utilize a master prepared nurse to practice across the continuum of care within diverse healthcare setting in today’s changing healthcare environment (AACN, 2013).

According to the AACN (2013, pg. 4-5), “the foundation of aspects of CNL practice include:

1.Clinical leadership for patient-care practices and delivery, including the design,

coordination, and evaluation of care for individuals, families, groups, and populations.

2.Participation in the identification and collection of care outcomes.

3.Accountability for evaluation and improvement of point-of-care outcomes, including the synthesis of data and other evidence to evaluate and achieve optimal outcomes.

4.Risk anticipation for individuals and cohorts of patients.

5.Lateral integration of care for individuals and cohorts of patients.

6.Design and implementation of evidence-based practice(s).

7.Team leadership, management, and collaboration with other health professional team Members.

8.Information management or the use of information systems and technologies to improve healthcare outcomes.

9.Stewardship and leveraging of human, environmental, and material resources.

10.Advocacy for patients, communities, and the health professional team”.

In the Sotomayor’s report (2017), from 2010 to 2015, CNLs led substantial improvement in the incidence of patient falls, catheter-associated urinary tract infection, central line-associated blood stream infection, and hospital-acquired pressure ulcer on medical-surgical units. The CNLs are able to detect issues of the environment, cooperate with other health professionals, lead the health care team and comply with the trend in providing quality care and changes to improve the care in the diverse healthcare settings.

References

AACN. (2013). Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice. Retrieved from http://www.aacn.nche.edu/cnl/CNL-Competencies-October-2013.pdf.

Sotomayor, G (2017). CNE SERIES. Clinical Nurse Leaders: Fulfilling the Promise of the Role. MEDSURG Nursing, 26(1), 21-32. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?sid=415d8048-5d08-41df-945e-e66ab320dffc%40sessionmgr4006&vid=4&hid=4205.

Peer discussion 5

In healthcare there is constant stress of the phrase “Patient care advocate” meaning that as a healthcare worker you are the voice of your patient and want to do what is the safest and right by them with their thoughts in mind. With that said there is a lot of confusion on ways to be a better advocate. Also, within healthcare it is lost that you must also be an advocate for your fellow healthcare workers and look after one another. Some of these advocacy strategies that can be implemented in the workplace are: organizational plans, environmental analysis, stakeholder analysis, risk analysis, drafting goal objectives, and creating an action plan.

Taking a step back and analyzing the situation is the best thing that can be done to be a better advocate. To open your eyes and identify a problem and analyze it and then develop a plan of how to address the issue is the foundation of utilizing your advocacy strategies. Also, realizing what tools you have at your disposal within your work place; that being policy and leadership can also help when developing an action plan in order to help advocate for changes you wish to be seen.

Reference:

What is advocacy strategy? (2017). Retrieved September 10, 2018, from Worldanimal website: http://worldanimal.net/our-programs/strategic-advo…

Peer discussion 6

Identifying innovative strategies to create workplace change can reduce the fear and anxiety that comes with changing work environments. “Change can scare a lot of people, but in today’s workplace managing change is what keeps people relevant and being held accountable for managing change and making things better in your workplace is the new normal” (Llopis,2012, p.1). Change is a natural occurrence in life as well as work. Change can be terrifying but there are strategies that we can use to advocate for change minimize the negative effects of these changes.

I am active in Shared Governance and this is a great tool I utilize to make effective changes that enhance our nursing practices. For example, my unit specializes in palliative care. Through Shared Governance we devised a plan to make our palliative patients and their families feel more safe and secure on the unit. We created Palliative Care bags. The bags include medication literature, flameless candles, Lavender patches, pen and paper, palliative literature and a warm hand-crafted blanket. The soft feeling of the blanket and the gentle scent of lavender has made all the difference to these patients making our bags a success. Through Shared Governance I can create changes that benefit not only my patients but their families and my coworkers as well.

I am also a member of the Violence committee and our fight for change has enforced security efforts and helped minimize the risk of violence towards nurses. Your voice is your greatest strategy to advocate for change in the workplace! If you speak loud enough, you can make certain your voice is heard. Sometimes we must speak more than once to be heard, but if we give up we will never see what difference we could have made if we just kept trying. Your voice can save lives! Your voice is the greatest strategy you can use to create change in your workplace.

Llopis, G. (2012) Five Effective ways to Sale Change. Retrieved from: https://www.forbes.com/sites/glennllopis/2012/11/0…