Pub Date : 2025-08-07DOI: 10.1016/j.mnl.2025.102480
Kali Dayton DNP, AGACNP
This article explores the transformation of critical care initiatives by Polly Bailey’s approach of keeping patients awake and mobile compared with the historical reliance on sedation and immobility. It highlights the detrimental effects of prolonged sedation and immobility, including patient harm (delirium and intensive care unit-acquired weakness) and system-wide burdens (increased costs and nursing workload). The ABCDEF Bundle is an evidence-based approach promoting patient wakefulness, autonomy, and mobility, and is presented as a solution. The case study of “Diane” demonstrates the gap between documented bundle compliance and actual patient care, revealing that sedation and immobility practices persist despite superficial implementation of the ABCDEF Bundle documentation. This document calls for nursing leadership to champion the ABCEF Bundle to change intensive care unit culture, transform patient outcomes, and improve the burden of patient care throughout the health care system.
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Nurses provide leadership in the changing health care landscape through their roles in health care design. Florence Nightingale was one of the first nurses involved in health care design, writing about her environmental theory. Today, nurses take on a variety of roles in the health care design industry to shape future health care settings. Nurses involved in health care design share how they came to design and the important nursing skills that enabled them to transition into these new roles. Utilizing evidence-based design and other resources allows nurses to apply their nursing knowledge to lead in new ways.
{"title":"Nurses Wear Hardhats","authors":"Terri Zborowsky PhD, RN, EDAC, Yolanda Keys PhD, DHA, RN, NEA-BC, EDAC, Jaynelle Stichler DNS, RN, NEA-BC(r), EDAC, FACHE, FAAN, Debbie D. Gregory DNP, RN, FAAN","doi":"10.1016/j.mnl.2025.102482","DOIUrl":"10.1016/j.mnl.2025.102482","url":null,"abstract":"<div><div>Nurses provide leadership in the changing health care landscape through their roles in health care design. Florence Nightingale was one of the first nurses involved in health care design, writing about her environmental theory. Today, nurses take on a variety of roles in the health care design industry to shape future health care settings. Nurses involved in health care design share how they came to design and the important nursing skills that enabled them to transition into these new roles. Utilizing evidence-based design and other resources allows nurses to apply their nursing knowledge to lead in new ways.</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 5","pages":"Article 102482"},"PeriodicalIF":1.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-06DOI: 10.1016/j.mnl.2025.102489
Beth A. Brooks PhD, RN, FACHE
{"title":"Exploring the Big Five Career Theories","authors":"Beth A. Brooks PhD, RN, FACHE","doi":"10.1016/j.mnl.2025.102489","DOIUrl":"10.1016/j.mnl.2025.102489","url":null,"abstract":"","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 5","pages":"Article 102489"},"PeriodicalIF":1.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-06DOI: 10.1016/j.mnl.2025.102485
Megan Carter DNP, RN, NEA-BC
Nurse leaders are increasingly stuck in survival mode, overwhelmed by staffing shortages, operational demands, and constant crisis response. This article introduces the concept of the “Chaos Whisperer”—a nurse leader who brings clarity and order to complexity through intentional time management, protected leadership time, and practical strategies. By adopting Chaos Whisperer techniques such as calendar triage, meeting streamlining, and technology optimization, nurse leaders can shift from reactive task management to proactive team engagement and retention. Sharing and scaling these best practices is essential to sustain nurse leadership capacity in today’s unpredictable health care environment.
{"title":"Nurse Leaders as Chaos Whisperers","authors":"Megan Carter DNP, RN, NEA-BC","doi":"10.1016/j.mnl.2025.102485","DOIUrl":"10.1016/j.mnl.2025.102485","url":null,"abstract":"<div><div>Nurse leaders are increasingly stuck in survival mode, overwhelmed by staffing shortages, operational demands, and constant crisis response. This article introduces the concept of the “Chaos Whisperer”—a nurse leader who brings clarity and order to complexity through intentional time management, protected leadership time, and practical strategies. By adopting Chaos Whisperer techniques such as calendar triage, meeting streamlining, and technology optimization, nurse leaders can shift from reactive task management to proactive team engagement and retention. Sharing and scaling these best practices is essential to sustain nurse leadership capacity in today’s unpredictable health care environment.</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 5","pages":"Article 102485"},"PeriodicalIF":1.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the rise of distance learning, especially postpandemic, the need for engaging, human-centered virtual education has become critical. This article explores the integration of joy and meaning into virtual nursing education, specifically aligning with Domain 10 of the AACN 2021 Essentials, which emphasizes personal, professional, and leadership development. The authors advocate for the intentional inclusion of play, art, music, and reflective practices to enhance learner engagement and well-being. Strategies such as gathering messages, gratitude reflections, themed sessions, guest speakers, and creative exercises like haikus are presented as effective tools to foster connection and joy. These approaches not only support the acquisition of nursing competencies but also align with the Institute for Healthcare Improvement’s framework for improving joy in work.
Pub Date : 2025-08-05DOI: 10.1016/j.mnl.2025.102483
Heather R. Bono PhD, Laura Caramanica PhD, RN, CNE, CENP, FACHE, FAAN
Many new nurse leaders are joining the ranks of frontline leadership with little or no managerial experience. Today’s frontline leaders are expected to navigate the complex business of health care. However, as new and inexperienced leaders, they struggle with foundational business skills—budgeting, cost justification, and resource optimization. This is not from a lack of capacity, but from gaps in education and insufficient institutional support to prepare them for their new responsibilities. This article is a call to action for educators and health care leaders to commit to collaboration and partnership in response to the critical need for frontline nurse leaders’ attainment of required business skills commensurate with their role responsibilities.
{"title":"The Business of Health Care","authors":"Heather R. Bono PhD, Laura Caramanica PhD, RN, CNE, CENP, FACHE, FAAN","doi":"10.1016/j.mnl.2025.102483","DOIUrl":"10.1016/j.mnl.2025.102483","url":null,"abstract":"<div><div>Many new nurse leaders are joining the ranks of frontline leadership with little or no managerial experience. Today’s frontline leaders are expected to navigate the complex business of health care. However, as new and inexperienced leaders, they struggle with foundational business skills—budgeting, cost justification, and resource optimization. This is not from a lack of capacity, but from gaps in education and insufficient institutional support to prepare them for their new responsibilities. This article is a call to action for educators and health care leaders to commit to collaboration and partnership in response to the critical need for frontline nurse leaders’ attainment of required business skills commensurate with their role responsibilities.</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 6","pages":"Article 102483"},"PeriodicalIF":1.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-30DOI: 10.1016/j.mnl.2025.102481
Yulia Lopez PhD, RN, Diana Layne PhD, RN, CPHQ, Susan D. Newman PhD, RN, CRRN, FAAN
Nurse managers play a critical role in workforce stability, yet they face significant stress and risk of burnout. While burnout has been extensively studied, professional fulfillment remains underexplored in this population. This qualitative study analyzed open-ended responses from a national survey to explore how nurse managers define professional fulfillment. Findings included intrinsic and extrinsic dimensions such as impact, self-worth, satisfaction, staff and patient well-being, and supportive work environments. These results suggest that current professional fulfillment models may not fully capture the leadership experience, indicating the need for expanded frameworks and organizational investment.
{"title":"Exploring Professional Fulfillment in Nurse Managers","authors":"Yulia Lopez PhD, RN, Diana Layne PhD, RN, CPHQ, Susan D. Newman PhD, RN, CRRN, FAAN","doi":"10.1016/j.mnl.2025.102481","DOIUrl":"10.1016/j.mnl.2025.102481","url":null,"abstract":"<div><div>Nurse managers play a critical role in workforce stability, yet they face significant stress and risk of burnout. While burnout has been extensively studied, professional fulfillment remains underexplored in this population. This qualitative study analyzed open-ended responses from a national survey to explore how nurse managers define professional fulfillment. Findings included intrinsic and extrinsic dimensions such as impact, self-worth, satisfaction, staff and patient well-being, and supportive work environments. These results suggest that current professional fulfillment models may not fully capture the leadership experience, indicating the need for expanded frameworks and organizational investment.</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 6","pages":"Article 102481"},"PeriodicalIF":1.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 10.1016/j.mnl.2025.102479
Mark Lee DNP, RN, NEA-BC, Sharon Pappas PhD, RN, NEA-BC, FAAN, Ron Yolo DNP, MBA, RN, NEA-BC
Strong professional governance is linked with higher levels of nurse engagement and lower levels of nurse turnover. Nevertheless, a large academic medical center found that professional governance engagement declined after the pandemic. A quality improvement project utilizing the Plan-Do-Study-Act methodology was developed to innovate professional governance, developing and implementing a service line council across eight medical–surgical units of a hospital service line sharing greater clinical, administrative, and educational resources than before. Over 3 months, the project indicated a statistically significant difference in the mean work empowerment scores of clinical nurses participating postsurvey (23.29 out of 30), compared to presurvey (19.75), t = 3.62, df = 31.8, p = .001. The results demonstrate the importance of aligning professional governance with evolving clinical and administrative structures for patients and the profession.
强大的专业管理与更高水平的护士参与和更低水平的护士流动率有关。然而，一家大型学术医疗中心发现，疫情后，专业治理参与度有所下降。利用“计划-行动-研究-行动”方法制定了一个质量改进项目，以创新专业治理，在医院服务线的八个外科医疗单位中建立和实施服务线委员会，共享比以前更多的临床、行政和教育资源。3个月后，参与项目的临床护士的工作授权平均得分（23.29分/ 30分）与调查前的19.75分（t = 3.62, df = 31.8, p = .001）相比有统计学意义。结果表明，调整专业治理与不断发展的临床和管理结构对患者和专业的重要性。
{"title":"Engaging Nurses in Professional Governance Across a Hospital Service Line","authors":"Mark Lee DNP, RN, NEA-BC, Sharon Pappas PhD, RN, NEA-BC, FAAN, Ron Yolo DNP, MBA, RN, NEA-BC","doi":"10.1016/j.mnl.2025.102479","DOIUrl":"10.1016/j.mnl.2025.102479","url":null,"abstract":"<div><div>Strong professional governance is linked with higher levels of nurse engagement and lower levels of nurse turnover. Nevertheless, a large academic medical center found that professional governance engagement declined after the pandemic. A quality improvement project utilizing the Plan-Do-Study-Act methodology was developed to innovate professional governance, developing and implementing a service line council across eight medical–surgical units of a hospital service line sharing greater clinical, administrative, and educational resources than before. Over 3 months, the project indicated a statistically significant difference in the mean work empowerment scores of clinical nurses participating postsurvey (23.29 out of 30), compared to presurvey (19.75), <em>t</em> = 3.62, <em>df</em> = 31.8, p = .001. The results demonstrate the importance of aligning professional governance with evolving clinical and administrative structures for patients and the profession.</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 5","pages":"Article 102479"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As health care increasingly relies on digital tools, nurse leaders are expected to navigate complex communication environments with fluency, strategy, and ethical awareness. This Delphi study aimed to identify and validate a set of digital communication competencies essential for contemporary nurse leadership. A two round Delphi process engaged a diverse panel of 29 nurse leaders to evaluate proposed competencies derived from literature and practice. Through both qualitative feedback and quantitative consensus (≥70% agreement), nine key competencies were confirmed: Ethical Digital Communication, Digital Leadership Presence, Engagement and Advocacy, Digital Inclusivity, Boundaries, Networking, Branding, Storytelling, and Measuring Digital Impact. The framework is grounded in established leadership theories, including e-leadership, transformational, and situational leadership. These competencies provide a much-needed foundation to inform leadership development, digital literacy initiatives, and strategic communication efforts in nursing. As digital communication continues to reshape health care leadership, this framework offers timely guidance for advancing influence, visibility, and collaboration in digitally connected environments
{"title":"Reimagining Communication in the Digital Era of Nursing Leadership","authors":"Alysia Adams DNP, APRN, AGACNP-BC, CCRN, NE-BC, Rosa Hart BSN, RN, SCRN, Rachel Malloy DNP, RN, CNRN, SCRN","doi":"10.1016/j.mnl.2025.102477","DOIUrl":"10.1016/j.mnl.2025.102477","url":null,"abstract":"<div><div>As health care increasingly relies on digital tools, nurse leaders are expected to navigate complex communication environments with fluency, strategy, and ethical awareness. This Delphi study aimed to identify and validate a set of digital communication competencies essential for contemporary nurse leadership. A two round Delphi process engaged a diverse panel of 29 nurse leaders to evaluate proposed competencies derived from literature and practice. Through both qualitative feedback and quantitative consensus (≥70% agreement), nine key competencies were confirmed: Ethical Digital Communication, Digital Leadership Presence, Engagement and Advocacy, Digital Inclusivity, Boundaries, Networking, Branding, Storytelling, and Measuring Digital Impact. The framework is grounded in established leadership theories, including e-leadership, transformational, and situational leadership. These competencies provide a much-needed foundation to inform leadership development, digital literacy initiatives, and strategic communication efforts in nursing. As digital communication continues to reshape health care leadership, this framework offers timely guidance for advancing influence, visibility, and collaboration in digitally connected environments</div></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":"23 5","pages":"Article 102477"},"PeriodicalIF":1.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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