Advanced practice nurses are believed to play a crucial part in the current process of healthcare system transformation. At present, medical organizations tend to invest in improving patient care and developing the culture of nursing practice. To improve the quality of medical services, nurses should advocate for evidence-based and patient-centered health care. They are expected to collaborate with interprofessional teams and practice their leadership skills to achieve a higher quality of health care, as well as its cost-effectiveness and safety. The purpose of this paper is to evaluate how a master’s prepared nurse can impact the process of changes as a change agent.
Essential Qualities of an Effective Change Agent
It is a general opinion that one of the main qualities of advanced nursing practitioners is the ability to utilize their leadership skills to trigger changes in the current healthcare environment. Many initiatives proposed to improve the organizational structure in the medical system are unsuccessful because change agents fail to understand the individual’s behavior and their engagement in the complex modern environment. Thus, it is also important for a change agent to gain a contemporary way of thinking and understanding of organizational systems and various environments that trigger demands for changes. Some researchers state that “although nurse leaders and the public describe a variable level of influence ascribed to the nurse leader, the literature supports that an influential nurse leader can create a positive environment” (Ducharme, Bernhardt, Padula, & Adams, 2017, p. 369). It proves the suggestion that leadership skills help a master’s prepared nurse leader to establish a collegial relationship and provide a high level of collaboration and coordination of healthcare specialists, which assists in evaluating changes required in the hospital at the organizational level.
Importance of a Leadership Role
Nurses play an important role in the healthcare system because they provide services that influence the safety and satisfaction of patients. Therefore, without a nursing standpoint, changes in healthcare would be less effective and fail to meet the demands of people. It is stated that crucial nurse practitioners should use their leadership skills to achieve better patient, population, and community outcomes (Peltzer et al., 2015).
Leadership is regarded to be one of the components required for an advanced nurse practitioner. There are also such roles as education, research, and clinical practice. Still, the leadership role is the most essential one as it might be used to propose useful changes. Leadership capacity is usually dependent on strategy and support levels in the selected organization, which significantly influences possible changes. Some researchers emphasize that “in many countries, the advanced practitioner is considered a key leadership position of influence for innovation, improving clinical practice, healthcare delivery and advancing the nursing/midwifery professions” (Elliott, Begley, Sheaf, & Higgins, 2016, p. 28). It is generally recognized that nursing leaders significantly impact patient and organizational outcomes. In the healthcare system, transformational leadership is recognized to be most effective to accomplish the goals of transforming values and behaviors according to the requirements of healthcare reform.
Changes Required in the Healthcare System
In the United States, improvement of healthcare quality is a part of the federal policy to secure encouragement of healthy behavior and equal opportunities in receiving medical care. Some researchers note that “a fundamental goal of the U.S. health care system is to achieve optimum health outcomes among individuals, families, communities, and populations” (Peltzer et al., 2015, p. 118). Therefore, nurses are expected to lead changes that might improve healthcare service delivery to the various social classes of the population. They should participate in community coalitions and interprofessional initiatives to eliminate health disparities. Providing equal health care to all the social classes in the hospital is one of the current issues that require some organizational changes. The current medical system should be thoroughly revised to implement the needed change while reducing costs, negative outcomes, and medical errors.
Tools Used by a Nurse to Trigger Changes
The contemporary leadership model that can be applied to the selected healthcare delivery situation includes such elements as trust and transformational leadership. It is noted that standards of Magnet hospitals are based on the transformational leadership of master prepared nurses who foster a healthy professional practice environment (Ducharme et al., 2017). Thus, nurse leaders are expected to build a positive relationship with colleagues to encourage the best performance possible and empower collaboration and teamwork to meet the goals of the organization. Trust is defined as the basic element of transformational leadership and results in improving organizational effectiveness, less resistance to changes, and increasing information sharing and job satisfaction.
Successful leadership is based on professionalism, business skills, inspirational motivation, and interpersonal relationships (DeNisco & Barker, 2016). A professional nurse leader is self-aware while applying one’s experience, skills, knowledge, and values. Such a leader utilizes such factors as listening, intellectual stimulation, and an inspirational approach to achieve the required goals (Ducharme et al., 2017). They engage with groups and individuals to secure honest communication and open collaboration. Competent leader assists in achieving the best healthcare practices by applying the skills and competence of one’s colleagues.
According to the selected healthcare delivery situation, a certain change model can be applied. Usually, this model consists of several steps. Primarily, the nurse leader tries to develop personal acceptance and understanding of a practice change and to evaluate the potential benefits of its implementation (DeNisco & Barker, 2016). After understanding the nature of the problem, a nurse leader formulates why this specific change is necessary to implement. The second step involves collaborating with the interprofessional change team which is formed to implement the suggested change. Some researchers note that teamwork is based on the importance of all the members who develop a shared vision of the results of a change (Elliott et al., 2016). The next step is to detect and analyze the forces that resist and facilitate the discussed change. After that, a work plan is developed to implement the change.
Developing a Plan for Change
The proposed plan for change might include objectives, timelines, a suggested list of activities, and responsible individuals. It also describes the outcomes of the suggested actions. Some researchers state that participation of a nurse leader in the process of changes helps to shift from individual tasks to a broader understanding of the roles assigned to clinical staff (Elliott et al., 2016). The change required to eliminate social disparities in health care might include such steps as enhancing the list of services for new patients and suggesting packages of basic health care at a lower price. It might assist in improving healthcare equity and patient satisfaction.
Strategies Used to Initiate Changes
To initiate the change in the selected healthcare delivery situation and improve outcomes of its implementation, a nurse leader might utilize such strategy as providing data related to the hospital’s performance and comparing it to the performance of the competitors. Such information will be helpful to get a positive response from the top management who usually makes decisions based on the data and estimates the project’s costs and possible revenue. Some researchers state that “to effect changes in clinical practice or service delivery at the organizational level, advanced practitioners need support from key stakeholders” (Ducharme et al., 2017, p. 371). It is also advisable to explain the positive impact of the proposed change to other team members. Information from scholarly sources and successful experiences of other organizations might also influence the positive outcome. The vision and values of the expected outcomes should be discussed. The demonstration of the evidence related to the expected impact of the proposed change should explain why it is worth the effort and time.
Interprofessional Communication and Collaboration
The change process triggered to improve health outcomes involves interprofessional communication and collaboration between specialists in various fields. DeNisco and Barker (2016) state that “interprofessional collaboration describes the interactions among individual professionals who may represent a particular discipline or branch of knowledge but who additionally bring their unique educational backgrounds, experiences, values, roles, and identities to the process” (p. 126). The interprofessional team formed to implement the change deals with professionals addressing a particular part of population care. In such situations, physicians frequently compete with nurse leaders in assuming team leadership. Still, it is argued that nurse managers and leaders who possess knowledge about policy, strategic planning, and organizational structure can guide the analysis and change of the current system (Peltzer et al., 2015). Leadership skills of an advanced nurse practitioner might also assist in resolving conflicts between team members and achieve effective communication by the recognition of the value of each member.
The purpose of this paper was to evaluate how a master’s prepared nurse can impact the process of changes as a change agent. It was indicated that leadership skills play a crucial role in implementing changes in the healthcare system. The process of triggering and implementing changes was observed to understand the leading role of a nurse practitioner in proposing changes, making implementations plans, and collaborating with interprofessional teams. The strategies used to initiate changes were discussed as well.
DeNisco, S. M., & Barker, A. M. (Eds.). (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Ducharme, M. P., Bernhardt, J. M., Padula, C. A., & Adams, J. M. (2017). Leader influence, the professional practice environment, and nurse engagement in essential nursing practice. Journal of Nursing Administration, 47(7/8), 367-375.
Elliott, N., Begley, C., Sheaf, G., & Higgins, A. (2016). Barriers and enablers to advanced practitioners’ ability to enact their leadership role: A scoping review. International Journal of Nursing Studies, 60(1), 24-45.
Peltzer, J. N., Ford, D. J., Shen, Q., Fischgrund, A., Teel, C. S., Pierce, J.,… Waldon, T. (2015). Exploring leadership roles, goals, and barriers among Kansas registered nurses: A descriptive cross-sectional study. Nursing Outlook, 63(2), 117-123.