Nursing administration is considered a specialty in nursing. It takes certain characteristics to be able to successfully lead an organization. They must be able to communicate with people in various disciplines to keep the organization working as a whole. This paper will discuss the scope of practice of a nursing administrator and the history of how it evolved, and also different characteristics and leadership skills that a nursing administrator must have. It will also discuss the domains of competencies and my own strengths and weaknesses.
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Nursing administrators are dedicated to the “design, facilitation, supervision, and evaluation of systems that educate and/or employ nurses.” He or she is a registered nurse who chooses nurse administration as a specialty. “Nursing administration combines leadership practices and values to influence the future, oversee healthcare service delivery, inspire clinical practitioners, and promote the health and safety of individuals, families and significant others, groups, communities, and populations,” (American Nurses Association, 2009). This specialty, as an art, encourages positive outcomes by creating and nurturing a healthy work environment by: keeping plenty of resources, leading and encouraging change, and working with key partners and stakeholders. Nursing administration is also considered a science due to the fact that uses science with evidence-based practice to ensure patients are receiving the best care. It uses concepts from leadership, business, and public policy to achieve the best outcomes for the healthcare system (American Nurses Association, 2009).
Like nursing, nursing administration can be traced back to Florence Nightingale in the 1850s when she implemented changes in nursing by observing patients, and then collecting and analyzing outcome data. After the Crimean War, she returned to England and continued her studies of the health of the British army and collecting and analyzing data. Using Nightingale’s work, groups such as the Sisters of Charity or Sisters of Mercy visited sick patients in their homes and establishing hospitals, this helped control disease outbreaks in America (American Nurses Association, 2009).
Nurse administrators can work in a variety of places. Nursing schools need nurse administrators (program directors and deans) to lead nursing programs so that we can get new nurses into practice. There are nursing administrators in public health nursing, this started in 1893 when Lillian Wald and Mary Brewster started a program based on immigrant populations and then sent nurses into public schools in 1902. This started public health departments forming in different states. There are also administrators in hospitals; in the 1930s nursing administration was first recognized as a specialty and the “rise of hospitals and the development of a hierarchical structure in health care advanced the development of nursing administration practice,” (American Nurses Association, 2009).
We need nurse administrators because their influences stretch far beyond that of just nursing. They collaborate with all stakeholders, system wide to create the mission of the organization while upholding the unique perspective of nursing. The administrator has a big responsibility in that they are held accountable as to whether or not their organization is providing standard, safe, and cost-effective nursing practice across the healthcare system (American Nurses Association, 2009).
Nursing administration is a difficult job to have. Someone in this role must have certain characteristics that make them able to be respected by staff members. There are four main characteristics that make a respectable nurse administrator. The first is that of a “super integrator.” This trait means that this person can successfully align nursing practice, technology, and information and have a successfully running together over an entire system. They are self-motivated, ambitious, and determined (Crawford & Spicer, 2017). The second important trait of a Chief Nurse Executive (CNE) is that they are strategic and goal-driven. They must focus on making a difference to patients, nurses, and health care. The third characteristic is that they must be realistic. They must be able to “manage time, opportunities, and deficiencies with skill and grace.” The last characteristic of a strong CNE is competence. They must be highly educated and experienced in several different locations. “Executive leaders inspire and engage people. They manage behavior change by influence, rather than authority, and challenge the status quo while encouraging system loyalty,” (Crawford & Spicer, 2017).
A survey of nurse leaders was done to evaluate what they thought were important characteristics of a nurse executive. The first, and most important one, that they thought of was self-awareness. This is described as a constant process of examining strengths, weaknesses, and personal values. The second one that they thought was important was balanced processing. This refers to looking at opposing views and being open minded. The third most reported quality was transparency. They described this as having honesty and integrity, and being able to minimize inappropriate emotions, while still being able to share their thoughts and beliefs. The last important quality that the leaders named was moral leadership, which they felt was having “an ethical foundation for decision making learned early in their careers: doing what is in the best interest of patients, supporting the voice of the nurses, and finding joy in the work,” (Alexander & Lopez, 2018).
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I believe that I am strategic, and goal driven. When I have a project in mind, I work on it as much as I can to try and get it done, the best that I am able. I am realistic and efficient with my time. I have a very strong moral compass and try to have strong self-awareness. When I was a team leader, when I would get an email about changes coming soon, I would instantly start running ideas by my manager about how we as a unit can change to incorporate those changes.
There are five domains for establishing competency in a nursing administrator. Those domains are as follows: communication and relationship building, knowledge of the healthcare environment, environment, leadership, professionalism, and business skills and principles. The domain that I believe I am strongest in is knowledge of the healthcare system. I have worked in the healthcare field since I was 19 and worked in various rolls, from a nursing assistant, to management, and now as an educator I feel that I have a good bit of knowledge in several different areas. My weakest area would be business skills and principals. I have not worked very much in the business aspect of it (American Nurses Association, 2009). I am learning a lot in my clinical about the business side of it. When I finish my masters program, I will purchase a nurse executive study course to help me prepare sit to take my certification. I will graduate in August and could possibly take the certification test by December.
In conclusion, there are many characteristics that make a respectable nursing administrator. I had never thought about nursing administration as being a specialty in nursing, but it truly is. It takes someone with higher education to think about the big picture and be able to make decisions about what is best for the organization. I found it interesting that what was determined in one article to be important characteristics of a nursing administrator were more management type characteristics, but when you ask the leaders what were the most important qualities, they named things such as self-awareness, being open minded, and transparency, things that make them respectable to staff members.
- Alexander, C., & Lopez, R. (2018). A Thematic Analysis of Self-described Authentice Leadership Behaviors Among Experienced Nurse Executives. The Journal of Nursing Administration, 48(1), 38-43.
- American Nurses Association. (2009). Nursing Administration Scope and Standards of Practice. Silver Spring: NursingWorld.
- Crawford, C., & Spicer, J. (2017). An Integrative Review of 21st-Century Roles, Responsibilites, Characteristics, and Competencies of chief Nurse Executives A blueprint for the next generation. Nurs Admin Q, 297-309.
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