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Advocating Globally to Shape Policy and Strengthen Nursing’s Influence
Abstract
The International Council of Nurses is a federation of national nursing associations that works to enable nurses to speak with one voice so as to influence health policy and advance the profession of nursing. In this article the author highlights how nurses can advocate for the nursing profession by coordinating nursing actions to develop both public and healthcare-service policies. He addresses issues that are common in many parts of the world and provides examples drawn from real-life experiences that illustrate how nurses in El Salvador, Rwanda, Paraguay, Papua New Guinea, and Iran have worked in their countries to coordinate their actions and advocate for public and/or healthcare service policies within their countries. He concludes by noting that all nurses must do their part and use a wide range of opportunities creatively, and with clarity of intent, to improve the profession and the lives of the millions of people who depend upon us.
... Although comparable with some developing countries, the provision of health-care services in Iraq may be argued to be more difficult because of the instability and shortage of skilled staff. As a workforce, nursing staff may have little avenue for voicing their concerns [6] and would be most likely limited in the opportunity to engage in actions that would help realize the global vision of the International Council of Nurses to lead our societies to better health as evidenced in other developing places [8,9]. Therefore, it is timely to conduct research in Iraq that investigates the nature of nurse leadership viewsto inform future policy and stimulate the conversation based on nurses' voices at work. ...
... The ICN also places leadership as one of its five core values, along with inclusiveness, flexibility, partnership, and achievement [26]. Barton (2012) explains in his examination of how nurses can successfully advocate for change in developing countries, international research shows nurse leaders need to be 'competent, inspiring and honest' [8]". Therefore, it is vital to understand the nature of the existing leadership in such change contexts as Iraq to know how best to advocate for improvement. ...
... Therefore, this research suggests room for improvement and a need for further research that gives voice to both nurses and their supervisors.There would be value in exploring the potential of theNordic APN model that besides identifying leadership as a critical competency [30] identifies other competencies highly relevant to relational capacity building, such as coaching and guidance, consultation, and research. Future research can also learn from ICN's work in developing countries [8] and investigate how nurses and their supervisors may advocate for change [26]. In conclusion, these findings suggest an essential moral imperative to ensure the provision of individuals and health-care teams understand and make explicit their behaviors as influential leaders, to ensure the responsiveness of the health-care system in the face of ongoing challenges and need for change. ...
Background: While Iraq was once seen as a highly developed country, it is now categorized as 'developing' because of several decades of disruption and war. Since little is known about how this has impacted the overall health care system, it is clear that staffing hospitals' task is challenging in this current war-torn context, as is the nature of the work for the nursing staff for a variety of reasons. Moreover, it can be argued that nurses' leadership skills are of even greater importance given the complexities involved. Participants: this research explored over two hundred ward nurses' perceptions of their leaders' leadership behaviors through completing a survey. Method: the survey comprised twenty items, each of which described a leadership characteristic reflective of a transformative and adaptive style. The nurses rated how frequently their leaders behaved in these ways as described, on a five-point scale ranging from 'doesn't do' to 'always do.' These items are related to the three dimensions of personal behavior, mentoring, and motivational behavior. Results: The nurses' perceptions of their leaders' leadership behavior were influenced by their gender, educational background, and work experience. The results of t-tests showed statistically significant differences in these variables. These findings suggest an essential moral imperative to ensure that health-care organizations in Iraq are led by individuals and teams who display effective personal behavior, mentoring behavior, and motivational behavior (such as high-level communication skills; concern for their employees as persons and modeling effective behavior; and encouraging staff participation and giving recognition for significant work, respectively).Conclusion: This research identifies the characteristics of nurse leaders in a challenging workplace setting with limited resources. This work could enable nurse leaders to better adapt to working in these difficult circumstances, and ultimately facilitate the organization's ability to consider what support and education are needed for nurses leaders and staff.
... Nurses and midwives work in complex, global, multifaceted settings. Healthcare professionals across nations are aware that skills reaching beyond the bedside and unit level are needed to assure patient needs are met and quality health care is provided (Benton 2012;Clark et al. 2016). Defining and achieving global health and developing global nursing competency have been the subject of research and an increasingly important consideration in the preservice education of nurses and midwives who pursue discipline-specific education (Warren et al. 2016;Wilson et al. 2016). ...
... An area garnering increased attention is that of preparing nurse leaders (Blaney 2012). Development of global skills can focus the nurse and midwife to influence large-impact policy-level decisions (Benton 2012;Wilson et al. 2016). An expanded world view is the springboard to more robust and informed involvement and inclusion in policy-level discussions. ...
... Research is both the base of and the ballast for policy (Benton 2012). Examples of collaborative research include work in India to implement delayed cord clamping at birth, consistent with current evidence (Faucher et al. 2016); efforts in South Africa to detail and improve midwifery care during parturition (Downing & Hastings-Tolsma 2016); and efforts in sub-Saharan Africa to explore the impact of task shifting on nurse and midwifery scope of practice (Spies 2016). ...
Aim:
To provide a unique model for use in guiding global collaboration and policy to upscale nursing and midwifery partnerships.
Background and introduction:
Nurses and midwives across nations need skills reaching beyond the bedside and unit level in today's complex, global, multifaceted healthcare milieu. Thoughtful consideration, research and concomitant development of models to guide appropriate upscaling of nurse and midwifery capacity within and between nations are needed.
Discussion:
This article explores an integrated global approach to upscaling nurse and midwifery capacity using examples of partnerships between nursing and midwifery programmes across multiple continents.
Conclusion and implications for nursing:
Global nurse and midwifery capacity is effectively being developed using a myriad of approaches. A new model is presented to illustrate supports, strategies and activities to achieve intermediate and long-term goals for capacity building through strong and sustainable global partnerships.
Implication for nursing policy:
Development of global skills can focus the nurse and midwife to influence policy-level decisions. Human resource planning that can impact countrywide provision of health care begins in the preservice setting for both nurses and midwives. A global experience can be a value-added component to the well-rounded education of future nurses. Education during preparation for entry into practice is a strategic way to develop a worldview. Incorporating reflective practice can build skills and shape attitudes to prepare the new nurse to be comfortable as a global healthcare provider. An expanded world view is the springboard to more robust and informed involvement and inclusion in policy-level discussions.
... There are examples from low-and middle-income countries (LMICs) where nurses have worked either individually or collectively through professional organisations to advocate for enabling health policies (20). In Rwanda, the chief nurse and the national nursing association mobilised support for legislation to improve the quality of nursing education and professional standards (20). ...
... There are examples from low-and middle-income countries (LMICs) where nurses have worked either individually or collectively through professional organisations to advocate for enabling health policies (20). In Rwanda, the chief nurse and the national nursing association mobilised support for legislation to improve the quality of nursing education and professional standards (20). In Paraguay, the nursing association capitalised on the visit of the chief executive officer (CEO) of the ICN to highlight poor staffing levels in health facilities in the country and to propose solutions to address them (20). ...
... In Rwanda, the chief nurse and the national nursing association mobilised support for legislation to improve the quality of nursing education and professional standards (20). In Paraguay, the nursing association capitalised on the visit of the chief executive officer (CEO) of the ICN to highlight poor staffing levels in health facilities in the country and to propose solutions to address them (20). In Kenya, the Nursing Council was a critical stakeholder in the development of the national electronic database on the nursing workforce (21). ...
There has been increased emphasis globally on nurses' involvement in health policy and systems development. However, there has been limited scholarly attention on nurses' participation in policy-making in South Africa.
This paper analyses the dynamics, strengths, and weaknesses of nurses' participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy.
Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software.
The study found that nurses' participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses' participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses' views and inputs were considered and incorporated.
The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.
... Sin embargo, para permitir la plena participación en la gestión del cuidado es necesario un proceso estratégico de la inversión, orientada a la formación o profesionalización de la enfermería, mejorar la cantidad y calidad de los puestos laborales, fomentar el liderazgo en Enfermería y orientar mejor la prestación de los servicios. [1][2][3] La profesión de Enfermería en América Latina y Caribe, evidencia grandes contrastes en su desarrollo profesional y oportunidades laborales, producto de las desigualdades sociales, políticas, culturales y ambientales de sus países. 4 Las agrupaciones nacionales y regionales tanto de Centro América y el Caribe como las de Sur América, deben tener mejor claridad en el panorama de los gobiernos de la región. ...
... Es imperativo la capacidad competencial de estos profesionales en los diversos niveles de atención de salud en la promoción de la salud y prevención de la enfermedad, así como en el nivel asistencial, pero se requiere por parte de los gobiernos de esta región mejorar y/o fortalecer los sistemas o servicios de salud, así como el involucramiento de los profesionales en Enfermería en las estructuras de la macro y la meso gestión y participar en la toma de decisiones orientadas a las políticas en salud y cuidados de la salud. 3 Una mayor inversión implica suficientes Enfermeras y Enfermeros idóneos para ejercer la gestión del cuidado de la salud, desarrollar el liderazgo en la toma de decisiones influenciando las políticas y la ...
En los últimos años la salud ha adquirido un lugar de suma importancia y un proceso de restauración en la agenda global, debido a la pandemia sindemia producto del SARS-COV2, así también los cambios demográficos, socioeconómicos, epidemiológicos ambientales y los procesos políticos de los gobiernos que impactan la salud pública y los recursos humanos en salud...
... This may adversely affect their services and the overall health outcome of their patients. This agrees with Benton, [18] who submitted that nurses are marginally involved in health policy and are implementers of decisions imposed on them by other health-care professionals. It appears that the nursing profession has really been slow to recognize and utilize its power to support and impact health-care policy development or emphasize the need for nurses to participate in public policy formulation and political activities. ...
... It appears that the nursing profession has really been slow to recognize and utilize its power to support and impact health-care policy development or emphasize the need for nurses to participate in public policy formulation and political activities. [11,18] This is an essential requirement if nurses are to meet their responsibilities in providing optimal health for their communities and the nation. ...
Background: Nurses account for a significant proportion of the health-care workforce in most countries; however, they are marginally represented in policy decision-making. Aim: To assess nurses’ involvement in health research and policy making at a Federal Teaching Hospital in Nigeria. Materials and Methods: A cross-sectional design was adopted by using 305 nurses. Data collection was done by means of a validated questionnaire. Data were analyzed descriptively by using frequencies, percentages, means, and standard deviations. Results: The findings revealed that 71.1% of the respondents had been involved in research activity; however, only 16.6% had participated in a research study after school. The result also revealed that only 23.6% of the respondents had been involved in health policy decision-making in the hospital. Educational qualification did not have any influence on their involvement with research and policy development. The major barriers identified were lack of knowledge and relevant skills (89.8%), lack of organizational support (84.5%), and professional dichotomy (67.2%). The respondents strongly agreed that organizational support (94.4%), having interest in politics (89.8%), mentoring in research (84.6%), higher education in nursing (84.2%), funding of research (80%), and belonging to professional organizations (80%) will enhance their involvement in research and health policy decision-making. Conclusion: Nurses have not been adequately involved in research and policy development. Findings revealed organizational and individual factors as barriers to nurses’ involvement in the research and policy-making process. These findings, therefore, suggest strengthening nurses for effective participation in health policy and building support for research activities in nursing.
... This gives nurses a broad appreciation of health needs, an understanding of how factors in the environment affect the health of clients and their families, and insight into how people respond to different strategies and services. (Benton, 2012) Building resiliency in the health care system means expanding the definition of the mental health care team, to encompass the community-based resources that help to build health system, community and patient resilience. ...
... The findings from this study have relevance for nursing practice, as nurses are uniquely positioned to champion continuity of patient care, based on close working relationships with health care professionals, allied non-health care professionals and patients in various health care settings (International Council of Nurses;2016;Shamian, 2016). In particular, as members of the largest group of health care professionals (International Council of Nurses, 2016), nurses can come together to speak with one voice while advocating for public health policy development that captures their knowledge, skills, perspectives, lived experiences and insights from their day to day practice (Benton, 2012;International Council of Nurses, 2016;Shamian, 2016;Shamian et al., 2014). ...
Refugee and immigrant populations experience many pre‐ and post‐migration risk factors and stressors that can negatively impact their mental health. This qualitative study aimed to explore the system‐level issues that affect the access to, as well as quality and outcomes of mental health care for immigrants and refugees, with a particular focus on challenges in the continuity of patient care. A multidisciplinary group of health providers, including nurses, identified six themes including (i) perceived access to care; (ii) coordination amongst health care providers; (iii) patient connections with community organizations; (iv) coordinated care planning; (v) organizational protocols, policies and procedures and (vi) systemic and health care training needs. Although patient resilience is seen as a pivotal way for vulnerable populations to cope with hardship, there is a clear need for creating a resilient health care system that is able to anticipate and adapt to adverse situations. The findings from this study have implications for nurses, who are uniquely positioned to advocate for public health policy that improves the continuity of health care by creating systemic resilience.
... In 2010, the Lancet Commission on Education of Health Professionals for the 21st Century recognized the fundamental need for 'robust, competent and professionally capable workforce', and the incongruity between current health worker competencies and actual skills required in an increasingly global and interconnected world. The commission noted that although workforce shortages are recognized as a primary deterrent to improving health outcomes, the quality of the health workforce, specifically professionalism and leadership skills need to be addressed in order to make lasting, sustainable improvements in global health (Bhutta et al. 2010). Addressing these human resources for health challenges will be required to meet the 2030 Sustainable Development Goals (United Nations, 2015b). ...
... The role of nurses within policy forums and influential decision-making bodies within the global health space has been limited (World Health Organization, 2011). To increase participation of nurses in policy creation, the International Council of Nurses (ICN) recommended three key strategies: 'coordinating nursing actions, maintaining solidarity with the profession and developing strong leadership' (Benton 2012). Investing in academic structures is one important way to expand the effective participation of nursing in global health policy development. ...
Aim:
We highlight key components of emerging academic structures in global health nursing and explain how this investment can expand nursing's broader engagement in global health policy development.
Background:
Engaging nursing in global health policy development is vital to ensure the scale-up of effective health programmes. Globally, nurses promote development of interprofessional healthcare teams who are responsible for translating sound global health policy and evidence-based programming into practice. However, the role of nurses within policy forums and on influential decision-making bodies within the global health space remains limited, which reinforces suboptimal global health policy implementation.
Introduction:
Investment in globally engaged academic structures is an important way to expand participation of nursing in global health policy development.
Sources of evidence:
A review of the current knowledge and substantive findings related to academic structures promoting global health nursing was conducted, and included a directed search of institutional websites, related grey and peer-reviewed literature, and communication with top-tier schools of nursing in the United States, to identify specific developments in global health nursing academic structures.
Discussion/conclusion:
Effective academic structures promoting global health nursing include a framework of four critical components - Research, Education, Policy and Partnership. Academic structure type and core activities vary depending on institutional priorities.
Implications for nursing, health and social policy:
Increasingly, global health research, driven by individual nursing investigators, is expanding; however, in order to translate these advances into expanded involvement in global health policy development, academic structures within schools of nursing need to systematically expand educational opportunities, bolster research capacity and promote partnership with policymakers.
... Është shkruar shumë rreth natyrës së lidershipit dhe rëndësisë së tij në infermieri dhe në kujdesin shëndetësor (Benton 2012). Megjithatë, siç kemi përshkruar ne, liderët aktualë infermieror janë duke u përballur me një numër të pa precedent të sfidave dhe ndryshimeve, si të parashikuara ashtu edhe të paparashikuara, që i kërkojnë atyre të punojnë në mënyrë fleksibile dhe të shpejtë. ...
... Vetë banorët vendas janë duke ndihmuar në luftën kundër këtij problem të madh dhe kjo infermiere, që tani është pjesë e ekipit menaxhues vendas, është duke ndihmuar për zhvillimin e programeve në klinika të tjera për probleme të ngjashme. (Benton 2012) ...
... requires effective leaders who are able to elicit the best performance from staff, maintain the principles of patient-centered care, act as full partners with fellow professionals, be attentive to workers' concerns regarding workflow, encourage innovation, and maintain solidarity within the team (Benton, 2012). ...
... Providers gain intimate knowledge of the structural forces that impact health, which should extend them authority in shaping policy decisions; however, it is the political forces outside of the health care sector that are argued to hold greater influence over health care and health outcomes (Kickbusch, 2015). One way that providers can address systemic barriers and wield their influence is by engaging in public policy advocacy (Benton, 2012; Conference Board of Canada, 2018;Mikkonen & Raphael, 2010;World Health Organization, 2016). ...
While health care and social service students in Ontario are expected to graduate with competencies in policy advocacy, the lack of knowledge and skills negatively impacts their participation as licensed providers. This study used an exploratory, comparative case study methodology with a critical theory lens to identify the process of how community-based organizations engaged in public policy advocacy to create educational competencies for undergraduate curricula. Eight organizational leaders participated in semi-structured interviews that were transcribed and analyzed both inductively and deductively using major concepts from Kingdon's multiple streams theory to distinguish the policy advocacy process and Bloom's taxonomy to identify the knowledge, skills, and attitudes involved in public policy advocacy. Seven major educational competencies were formed by inductively analyzing the knowledge, skills, and attitudes and the activities outlined in the process model. This research provides professors with direction for program development to better prepare students for their role as advocate.
... Thus, nurses represent an untapped leadership resource in health systems seeking to develop stronger and more effective leaders. Advocates of inclusion of nurses-inleadership in health system design argue for a paradigm shift-from functional doers, to proactive organizational leaders in health systems strengthening (Benton, 2012;Crisp and Iro, 2018b;WHO, 2020). ...
Evidence regarding the role of nurses-in-leadership and how to engage nurses in policy decisions is minimal in sub-Saharan Africa. The purpose of this study was: (1) to assess the leadership practices of nurses-in-leadership in Uganda (by self-report) and from the perspective of 'followers' (dir-ect-report, peers, co-workers, other); and (2) to determine factors (positively) associated with leadership practices. We surveyed 480 nurses, 120 in leadership roles (Response Rate 57%) and 360 'followers' (Response Rate 60%), who were recruited from five hospitals in Kampala, Uganda. We used the Leadership Practice Inventory (Self and Observer), a project-specific demographic questionnaire and Denison's Organizational Culture Survey (DOCS). Sixty-three per cent of the respondents held a registered nursing certificate; 79% had received formal leadership training; 47% were based in private for-profit (PFP) hospitals, 28% in private not-for-profit (PNFP) and 25% in public hospitals. Among the five leadership practices, nurses-in-leadership used the practice of Model the Way (M ¼ 8.27, SD ¼ 1.30), Challenge the Process (M ¼ 8.12, SD ¼ 1.30) and Encourage the Heart (M ¼ 8.04, SD ¼ 1.51) more frequently (on a 10-point Likert Scale). Inspire a Shared Vision (M ¼ 7.82, SD ¼ 1.57) and Enable Others to Act (M ¼ 7.62, SD ¼ 1.66) practices were used less frequently. The same rank order was true for leadership scores from the perception of followers. However, leadership scores by followers were significantly lower (P < 0.01) than the nurse leader self-reported scores across all sub-scales. Leadership practice scores were higher in public than private hospitals (P < 0.0001). Organizational culture (OC) was associated (P < 0.001) with leadership practices. Although overall leadership practice scores were generally high, the less frequent use of Inspire and Enable practices suggests opportunities for targeted improvement. Moreover, differences between self-reported and leadership scores by followers suggest perception gaps between leaders and their followers. The positive relationship between public hospital settings and self-reported leadership practices among nurses-in-leadership suggests that important nursing leadership practices are possible even in a low-resource clinical setting.
... Regardless of the desired change, it has been identified that health professionals by and large are receiving insufficient educational preparation in public policy advocacy (Avolio, 2014;Benton, 2012;Lyons, et al., 2015). Therefore, the purpose of this paper is to present a particular case of nursing advocacy around voting rights to explore both the challenges inherent in this competency and to provide practical suggestions to support nurses who seek to enact public policy advocacy for social justice. ...
In February 2014, the Government of Canada under Stephen Harper introduced the 'Fair Elections Act'. This reform to the elections act removed provisions for access to voting for individuals lacking certain forms of identification. Noting that this would have a disproportionate impact on people experiencing homelessness, nursing advocates joined with other activists to try to prevent then subsequently overturn this legislation. The purpose of this paper is to explore the 93 rd competency of the College of Nurses of Ontario, "Advocates and promotes healthy public policy and social justice," by unpacking a case example of advocacy for voting rights. This paper addresses the challenges faced by nurses in doing public policy advocacy and concludes with lessons learned. Fulfilling our college mandated requirement to be politically active means ensuring that public policies are just, equitable, and reflective of the progressive values of Nursing.
... ICN believes that all nurses should contribute to public policy development and planning related to care delivery systems, health care financing, ethics in health care and determinants of health (Benton, 2012). As a group, nurses have a massive potential to build and expand our political capital. ...
Nigeria is a country that has stood tall in Africa and features prominently in global affairs, yet her healthcare system has suffered several downfalls. Despite her position as a country with huge human and natural resources, her health facilities are grossly inadequate, especially in rural communities and this robs her citizen of optimum health care. Good health is one of the fundamental human rights and the onus rests on the healthcare system to provide health services for health care consumers. A healthcare system is an organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. Such a healthcare system must have a good health services, a well-performing health workforce, and well-functioning health information system that ensures equitable access to essential medical products, vaccines and technologies, a good health financing system and good leadership and governance for quality, efficiency, acceptability, and equity. Available evidence posits that the Nigerian healthcare system has failed in all these indices. Nevertheless, nurses by virtue of their education, expertise, numerical strength and position as the first point of contact with patients, are well positioned to champion health care transformations. These reforms are needed for a strong and sustainable healthcare system. This paper discusses the Nigerian healthcare system and the role of the nurse in building a strong and sustainable health care system in Nigeria.
... LPC programının kabul edildiği 1995 yılından sonra liderlik temalı dergilerin sayısında artış görülmektedir. LFC programı ülkelerin hemşire liderlik sürecinde becerileri geliştirmek amacıyla kurulmuş bir programdır[19]. LFC programı yıllar içerisinde farklı amaç ve odakları yönelik olarak güncellenmiştir. Programın son revizyonunda hemşirelik liderliğinin odağı "hemşirelerin karmaşık sosyal ve sağlık politikalarıyla uyumlu olarak mesleğin gelişimi ve toplumun tüm kesimleri için daha sağlıklı bir gelecek kurgusuna liderlik edebilecek ve hemşirelik hizmetini sağlayabilecek bilgi, strateji ve beceriye sahip olma" şeklinde belirlenmiştir[20].Hemşirelik rolleri alt araştırma alanı ise bu dönem sonrasında ortaya çıkan ve güncelliğini devam ettiren bir diğer alt araştırma alanı olarak değerlendirilmektedir. ...
Aim: The aim of this study to investigate leadership researches in nursing by bibliometric
methods in terms of a retrospective approach in nursing literature.
Method: The study has a quantitative research and includes Social network analysis which
was based on the metadata of articles. The dataset was compiled from nursing leadership
journals which are spanned from 1978 to 2017. In order to determine periodical changes, data was layered into 3 periods. The first period covers the year between 1978 to 1983 (n=99). The second period includes the between the year 1998 to 2009 (n=968). The last one covers the
year 2010 and 2017 (n=925). Author Keyword co-occurrence analysis and visualization have
been used to interpret the results of social network analysis.
Findings: Each period has unique properties and sub fields regarding to research themes.
Thus, in order to define sub research fields, social network graphs of each period have been
clustered. First period was clustered into 4 subfields. Those fields are “Education, Job
Satisfaction, Occupational Research, and Sociological Role” and they totally cover %87 of
the whole graph. The second period can be clustered into 3 subfields. These are “Nursing
Roles, Education and Organizational Behavior” and covered by 93% of the whole graph. The
last period was gathered under 7 subfields that they can called as “Education, Leadership,
Organization and Management, Employee Management, Evidence Based Nursing, Nursing
Roles, Cross Cultural Studies” and cover %98 of the social network graph.
Conclusion: Leadership in nursing can be seen as an interdisciplinary research field that has
evolved during the development of the field. The results of the study provide critical data for
the future of studies that are focused on leadership in nursing. It is highly recommended that
future research should focus on the sub research groups that were identified in the findings of current research.
... Nurses stand in an innovative position and are able to direct the community needs toward solutions. Benton (2012) states that nurse leaders are "transforming agents, effective in bringing about change." By engaging in leadership through training and policy discussions, nurses are able to assess, plan for, and evaluate the health system's resources. ...
... Nurses stand in an innovative position and are able to direct the community needs toward solutions. Benton (2012) states that nurse leaders are "transforming agents, effective in bringing about change." By engaging in leadership through training and policy discussions, nurses are able to assess, plan for, and evaluate the health system's resources. ...
This paper discusses the processes of harmonization of various approaches by partners that have been implemented in Zambia, in an attempt to overcome the fragmented implementation of Community based primary healthcare (CBPHC) systems strengthening, facilitated by multiple non-governmental organizations (NGOs) and donors, impeding country ownership and nationalization. To achieve equitable and sustained improvements in health, social and economic development outcomes for all, there is evidence that governments should consider building CBPHC systems based on three legs namely: 1. Front-line health workers trained, supervised and able to deliver services; 2. Community engagement through interactions to enhance community participation and Social Accountability for delivery of healthcare services; 3. Enabling environments through strengthening of community health systems. To realize a harmonized approach and alignments, the government and key stakeholders must uphold a common vision ensuring that all the three legs of CBPHC systems are implemented to scale. In evaluating the health system in Zambia and the related healthcare provision at community level, gaps were identified in the available mechanisms for the provision of quality CBPHC thus necessitating processes of harmonization, that include capacity building and orientations at all levels on importance of taking to scale the three legs of CBPHC systems, revision of the Community Health Strategy, and elaboration of Operational Guide for Neighbourhood Health Committees, clarifying the role of NHC as platform for community engagement and Community-Based Volunteers (CBVs). There is need for harmonization of health systems at national, provincial, district, zonal and communal levels to ensure the delivery of quality, cost-effective healthcare as close to the family as possible.
... Nurses stand in an innovative position and are able to direct the community needs toward solutions. Benton (2012) states that nurse leaders are "transforming agents, effective in bringing about change." By engaging in leadership through training and policy discussions, nurses are able to assess, plan for, and evaluate the health system's resources. ...
Background:
Despite its achievements in decreasing HIV prevalence and under-five mortality, Zambia still faces high maternal and neonatal mortality, particularly in the rural and remote areas where almost 60% of the population resides. After significant investments in developing its community health system, the Zambian Ministry of Health was interested to understand how to leverage the role of nurses to sustain achievements made and further improve the quality of care in rural communities. The Ministry joined research partners in an assessment into the role and leadership capacity of nurses heading rural health facilities.
Methods:
A seven-member research team conducted 30 in-depth interviews and 10 focus group discussions in four provinces with four categories of respondents: national decision-makers, provincial and district managers, rural facility staff and community respondents (neighborhood health committee members and volunteers). An initial scoping visit and literature review informed the development of specific interview guides for each category of respondent. After audio-recording and transcription, research team members identified and reached consensus on key themes, and presented and validated the findings at a national stakeholder workshop.
Results:
Zambia's front-line health teams are a complex mixture of professional facility staff, community providers, community-based volunteers and neighborhood health committees. Nurses and nurse-midwives head over half the rural facilities in Zambia, where they are expected to lead the delivery of safe, high-quality care with staff and volunteers who often operate beyond their level of training. Nurses and midwives who are assigned to head rural facilities are not adequately prepared or recognized for the leadership responsibilities they are expected to fulfill.
Conclusions:
This paper highlights opportunities to support rural facility heads in effectively leading front-line health teams to deliver primary healthcare to rural communities. Front-line teams require a leader to coordinate and motivate seamless and sustainable quality services that are accessible to all. Zambia has the potential to support integrated, responsive quality care and advance toward universal health coverage if nurses are adequately prepared and recognized with job descriptions that reflect their responsibilities and opportunities for career advancement.
... The voice of nurses shapes the policy seed that will eventually be planted and implemented; ensuring nurses' condition and perspectives to be heard is an important factor in influencing the effectiveness and efficiency of the health sector (Benton, 2012). It is imperative, therefore, to understand deeper, from the voice of nurses, what it means to be a Florence Nightingale and what vision they see for the profession. ...
Work environment has been described as an important factor in the job satisfaction of nurses and their quality of service provided. However, little is known of the present work environment of Filipino nurses in the country. This study used a cross-sectional design to describe work environment variables affecting Filipino nurses; determine the degree of nurses' job satisfaction;, and determine their intention to remain in their present work environment. A self-administered survey was developed by the study team and was distributed during the PNA national conference through the Chapter Presidents. This study discovered that the lowest positive responses were in the Physiologic and Safety Needs but despite this result, nurses reported high job satisfaction and intend to remain in their present work environment.
... The voice of nurses shapes the policy seed that will eventually be planted and implemented; ensuring nurses' condition and perspectives to be heard is an important factor in influencing the effectiveness and efficiency of the health sector (Benton, 2012). It is imperative, therefore, to understand deeper, from the voice of nurses, what it means to be a Florence Nightingale and what vision they see for the profession. ...
Purpose: This research explored the voices of nurses in contemporary times and unraveled nurses' situations for the purpose of generating a substantive theory to guide and refine nursing practice. Method: The grounded theory methodology of qualitative research was utilized patterned mainly in the works of Glaser and Strauss. Criterion sampling was used in the selection of 31 participants and the basis for selection was employment in the hospital, academe, and community and being part of different levels of management (nurses from top, middle, first, and staff levels). Theoretical sampling also informed the final list of study informants and was conducted by snowballing that consisted of 10 participants. The data gathering procedures included the combination of interviews, observations, and document and literature analysis. Findings: The study revealed three major themes: (1) nursing as a profession, (2) Nightingale in the 21st century: life of a nurse in today's context, and (3) the challenges and opportunities to quality of nursing care. Conclusion: Nursing is dynamic, complex, diverse, expanding and highly contextualized. Nursing is a field that grows with time and nurses are adaptive to the widening demands of their profession. The goal of nursing remains a Nightingale's pledge and an endeavor amidst nurses' constant battle between motivations and challenges. The Integrated Systems Approach to Nursing Care model was developed to be used as a framework for sound decision-making in nursing practice. Nursing, nightingale and beyond is a picture of struggles, success, and potential solutions to the predicaments surrounding the nursing profession. Clinical Relevance: The study has potential to help health managers and policy implementers in providing assistance to nurses in enhancing their knowledge and skills, increasing their emotional and psychological resilience and in revitalizing their commitment to the nursing profession. It may also aid in the reconsideration of institutional policies and set-ups toward collaborative and enabling work environment. In addition, it may serve as a guide in creating proactive health governance, in facilitating nurses' work motivation and retention through the due implementation of nursing law and other statures for the welfare of health workers, in providing additional plantilla position for nurses in the country, and in increasing funding for health programs to create more learning and practice environment for nurses. Lastly, the utilization of the theory can be used in developing a more responsive nursing practice.
... The voice of nurses shapes the policy seed that will eventually be planted and implemented; ensuring nurses' condition and perspectives to be heard is an important factor in influencing the effectiveness and efficiency of the health sector (Benton, 2012). It is imperative, therefore, to understand deeper, from the voice of nurses, what it means to be a Florence Nightingale and what vision they see for the profession. ...
Purpose: This research explored the voices of nurses in contemporary times and unraveled nurses' situations for the purpose of generating a substantive theory to guide and refine nursing practice. Method: The grounded theory methodology of qualitative research was utilized patterned mainly in the works of Glaser and Strauss. Criterion sampling was used in the selection of 31 participants and the basis for selection was employment in the hospital, academe, and community and being part of different levels of management (nurses from top, middle, first, and staff levels). Theoretical sampling also informed the final list of study informants and was conducted by snowballing that consisted of 10 participants. The data gathering procedures included the combination of interviews, observations, and document and literature analysis. Findings: The study revealed three major themes: (1) nursing as a profession, (2) Nightingale in the 21st century: life of a nurse in today's context, and (3) the challenges and opportunities to quality of nursing care. Conclusion: Nursing is dynamic, complex, diverse, expanding and highly contextualized. Nursing is a field that grows with time and nurses are adaptive to the widening demands of their profession. The goal of nursing remains a Nightingale's pledge and an endeavor amidst nurses' constant battle between motivations and challenges. The Integrated Systems Approach to Nursing Care model was developed to be used as a framework for sound decision-making in nursing practice. Nursing, nightingale and beyond is a picture of struggles, success, and potential solutions to the predicaments surrounding the nursing profession. Clinical Relevance: The study has potential to help health managers and policy implementers in providing assistance to nurses in enhancing their knowledge and skills, increasing their emotional and psychological resilience and in revitalizing their commitment to the nursing profession. It may also aid in the reconsideration of institutional policies and set-ups toward collaborative and enabling work environment. In addition, it may serve as a guide in creating proactive health governance, in facilitating nurses’ work motivation and retention through the due implementation of nursing law and other statures for the welfare of health workers, in providing additional plantilla position for nurses in the country, and in increasing funding for health programs to create more learning and practice environment for nurses. Lastly, the utilization of the theory can be used in developing a more responsive nursing practice.
... Global service-learning, community and civic engagement provide faculty and nursing students experiences to serve communities and populations in meaningful ways thereby reducing health disparities and social injustice. Through international academic-community partnerships, students develop an appreciation and understanding of the cultural and health care contexts in which their nursing skills are needed while learning about the role of the nurse as citizen and social advocate [18] . ...
Two nursing faculty from the United States and one from South Africa established a partnership to address a mandate of the University of Johannesburg calling for the integration of service-learning and community engagement into all programs at the university, including those in the nursing department. In descriptions of the faculty partnership and 2012 Service-Learning Conference, this article highlights the challenges that emerged when developing an undergraduate nursing service-learning and community engagement program for a vastly diverse culture with extensive obstacles to communication and collaboration. The outcomes of the Conference allowed for the exchange of knowledge and skills in service-learning pedagogy to advance the civic, personal, and social development of nursing faculty and students in South Africa’s diverse culture and to foster collaboration on improving healthcare for vulnerable populations.
... This is imperative because lone voices can do little. Studies in many countries suggest that professional nursing associations are the platforms through which nurses' voices can be heard [53][54][55][56]. Similarly, Abood and Carnegie and Kiger asserted that it is essential for nurses to gain confidence in collective action to take on some form of advocacy to bring about change in the current policies, laws, or regulations that govern the larger health care system [13,45]. ...
Background of study: Nigerian national policy on HIV stresses the need for the adoption of multi-sectoral and multi-disciplinary approach in policy formulation, with the health sector taking the lead. This calls for collaboration among the various stakeholders including nurses in policy development initiatives to ensure that diverse health care needs and disciplinary perspectives are captured in HIV health policies.
Purpose: This paper will present the findings of a recent study which examined nurse’s involvement in policy development in the context of mother-to-child transmission (MTCT) of HIV in Nigeria.
Methodology: A qualitative case study design under the guiding tenets of critical social and power theories. The research is a single case study of one state with embedded units. Thirty nurse-leaders from the various embedded units were recruited through purposive and snowball sampling technique. Semi-structured in-depth interviews and document reviews were used for data collection. Focus group discussions were used as a form of member-checking and also to generate data. Data was analysed using thematic analysis.
Results: This paper focuses on the major themes that emerged from the study as well as highlight specific interplay of power dynamics in the health care system which hinders nurse’s involvement in policy formulation.
Conclusion: The paper concludes with some of the lessons learnt in the study and proffer suggestions for effective integration of nurses into policy arena. It suggests the need for a broad-based educational curriculum which will incorporate strategies to build nurses capacity for leadership and policy development in nursing training schools.
... Recently, some courses called the Leadership for Change (LFC) are held by INO for Iranian nursing managers. These courses are supervised by the International Council of Nurses (ICN) (Benton 2012). The fact that nurse leaders need to pay attention to society needs is another facilitator discussed in this study. ...
Background: During recent years involvement of Iranian nurse leaders in policy making for nursing has been increased, but still there are many disputations about policy making for nursing in Iran. Objectives: This study intended to explore and describe factors effecting on Involvement of nurse leaders in policy making for nursing in Iran. Method: A qualitative design involving face-to-face, semi-structured interviews by 20 nurse leaders and physicians who had key positions in policy making for nursing had been audio taped and transcribed. Using a conventional content analysis approach, data were analyzed. Results: After open coding and categorizing data three main categories created; include: performance of nurses and nurse leaders; opportunities face to nurse leaders; and conditions governing the healthcare system. Conclusion: Some factors effecting involvement of nurse leaders in policy making for nursing in Iran do not have wide differences with other studies in this field. Although many factors had been mentioned in this study, frequency of codes showed that performance of nurses and nurse leaders acted as a barrier and have had the most effects on involvement. Meanwhile, despite the obstacles, there are abundant opportunities before nurse leaders to making policies and they should apply them to modify these obstacles. Keywords: Health System, Involvement, Iran, Nurse Leaders, Policy Making.
... It is also difficult to determine if cares are carried out more consistently when an evaluator is present versus when there is no evaluator present. Some barriers to the consistent application of acquired skills in the clinical setting may include lack of administrative support, poor hospital infrastructure, and high staff turnover rates [11]. ...
Background: Nursing care quality in developing countries is an ongoing challenge leading to poor patient outcomes. The objective of this study is to evaluate changes in nursing performance providing routine cares following a training program in children’s hospital in Mota Fofalia, Gujarat, India. Methods: The main outcome measure was the proportion of newborns with vital signs and weights obtained by nursing staff before and after a training program. The training program consisted of an in-service reinforced by hands-on management of patient care for 2 weeks. Following the training, the nurses were observed for 2 months. Results: Observation of 138 newborn encounters demonstrated a 29.7% improvement in vital sign monitoring and 88.4% in weight monitoring from the 0% baseline. Conclusion: We observed a moderate improvement in measuring vital signs and a substantial improvement in measuring weights in newborns with the training intervention. For further improvement, continued training, and follow-up is indicated.
... Recently, some courses called the Leadership for Change (LFC) are held by INO for Iranian nursing managers. These courses are supervised by the International Council of Nurses (ICN) (Benton 2012). The fact that nurse leaders need to pay attention to society needs is another facilitator discussed in this study. ...
... In Iran, nurse managers and PhD students can also benefit from these programs in graduate studies. For example, the Leadership For Change (LFC) program is mostly the reinforcement of leadership skills and change management (Benton, 2012), Nevertheless, for gaining more benefit from the LFC program, taking some other courses are also necessary, such as courses in the Management Business Organization (MBO), mini-MBOs, health policymaking, health economics and entrepreneurship. MBO courses are currently being offered in Iran by the MBO Association of Iran for different businesses. ...
BACKGROUND: The product of the educational nursing programs in Iran is training nurses who less have professional apprehension and commitment for participating in professional decisions. Whereas nurses especially those in high academic levels are expected to more involve in professional issues. OBJECTIVE: The aim of this study was to explore Iranian nurse leaders' experiences of making educational nursing policy with emphasizes on enhancement of nurses' participation in professional decisions. METHODS: We used a qualitative design with thematic analysis approach for data gathering and data analysis. Using purposive sampling we selected 17 experienced nurses in education and making educational nursing policies. Data gathered by open deep semi-structured face to face interviews. We followed six steps of Braun and Clarke for data analysis. RESULTS: In order to enhance nurses' participation in professional decisions they need to be well educated and trained to participate in community and meet community needs. The three main themes that evolved from analysis included opportunities available for training undergraduate students, challenges for PhD nurses and general deficiencies in nursing education. The second theme includes three sub-themes; namely, the PhD curriculum, PhD nurses’ attitudes and PhD nurses’ performance. CONCLUSIONS: We need for revising and directing nursing education toward service learning, community based need programs such as diabetes and driving accidents and also totally application of present educational opportunities. The specialization of nursing and the establishment of specialized nursing associations, the emphasis on teaching the science of care and reinforcing the sense of appreciation of pioneers of nursing in Iran are among the directions offered in the present study
... And more nurses need to be supported to attend international conferences to play their part in providing a balanced view of nursing, care and life here in Iran. As I said in my article in the Online Journal of Issues in Nursing the Iranian Nursing Organization has achieved an enormous improvement in a relatively short time (5). They are active across the country to reach out to their colleagues in other parts of the world and importantly they work regularly with all forms of media here in the country. ...
... While leadership competencies have been recognized as key attributes to shaping and influencing policy [46,47], in this study nursing leadership was viewed as internal to the nursing profession, with concerns about the focus on nurses' work issues and not general health care issues. Nursing champions should not focus on the profession alone; they must be educated in the broader health systems issues and become patient advocates for health care as they engage with other professionals in leading policy change [48]. This engagement would contribute to health systems improvement. ...
The aim of this study was to critically examine how nurses have been involved in national policy processes in the Kenyan health sector. The paper reports qualitative results from a larger mixed method study. National nonnursing decision-makers and nurse leaders, and provincial managers as well as frontline nurse managers from two Kenyan districts were purposefully selected for interviews. Interviews dealt with nurses' involvement in national policy processes, factors hindering nurses' engagement in policy processes, and ways to enhance nurses' involvement in policy processes. Critical theory and feminist perspectives guided the study process. Content analysis of data was conducted. Findings revealed that nurses' involvement in policy processes in Kenya was limited. Only a few nurse leaders were involved in national policy committees as a result of their positions in the sector. Critical analysis of the findings revealed that hierarchies and structural factors as well as nursing professional issues were the primary barriers constraining nurses' involvement in policy processes. Thus, there is need to address these factors both by nurses themselves and by nonnursing decision makers, in order to enhance nurses engagement in policy making and further the contribution to quality of services to the communities.
Cerrahi hasta bakımının bir neticesi olarak görülen cerrahi bakım sonuçları, sağlık bakım hizmetlerinin kalitesini ölçen önemli bir parametredir. Sağlık bakım hizmetlerinde daha kaliteli hasta bakımı verilebilmesi, sunulan hizmette gerekecek iyileştirmelerin belirlenmesi ve çözüm önerilerinin oluşturulabilmesi için cerrahi bakım sonuçlarını etkileyen faktörlerin bilinmesi önem arz etmektedir. Hastaların cerrahi hemşireliğinde bakımın kalitesinden memnuniyeti, hastanelerde sağlanan bakımın niteliğini etkileyen en önemli unsurlardan biridir. Hastaların hemşirelik bakımının kalitesine ilişkin cerrahi bakım sonuçlarının ölçülmesi, hemşirelikte hizmet kalitesini arttırmakta ve aksayan yönlerin belirlenmesinde sağlık bakım yöneticilerine önemli bilgiler sunmaktadır. Cerrahi bakım sonuçları, hastalar tarafından algılanan kalite düzeyini izlemekte ve sonuçlar doğrultusunda bakıma ilişkin standartlar oluşturmakta, hasta beklentilerine yönelik hemşirelik uygulamalarında gerekli düzenlemelerin yapılmasına olanak sağlayarak hemşirelik hizmetlerinin kalitesinin yükseltilmesinde etkili olmaktadır. Hemşirelerin hasta bakımını yönetmesi için doğru klinik kararlar alması gereklidir. Doğru klinik kararların alınması için hemşirelikte eğitim, sağlık politikaları, sektör temsilcisi olan hemşireler, cerrahi bakım sonuçlarında ölçme ve değerlendirme parametrelerinin önemli olduğunu göstermektedir.
Every day legislators make decisions that affect nursing practice, thus impacting care delivery and patient outcomes. Much of what nurses do and experience daily while caring for their patients is influenced directly by laws, regulations, and other policies. Nursing expertise and perspectives offer unique insights into patient care that benefit society. The advocacy role of nurses could help ensure that structural and process changes translate to a real-world patient and public health benefits. Nurses can leverage their position as the most honest and trusted profession to impact policy change in their local communities as well as nationally and globally. Learning about advocacy and policy can expand our influence and involvement in decision-making tables to drive positive change and shape the future of health care.KeywordsNurse advocacyHealthcare policyPolicymakingProfessional development
Background
Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes.
Objective
This study aimed at exploring the attitudes and perceived benefits of nurse managers’ participation in the health policy-making process.
Methods
In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012).
Results
After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers’ participation, advantages of nurse managers’ participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process.
Conclusion
The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers’ participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.
Background: The inability of nursing education institutions, particularly in low-resource settings to train competent nurses has been partly attributed to the challenges faced by nurse educators in the teaching of practical skills and in facilitating the development of clinical competence. Unfortunately, the perceptions and challenges faced by nurse educators in clinical nursing educationin diploma nursing education in low-resource settings have not been explored.
Purpose: This study aimed to explore and describe the perceptions and challenges of nurse educators in the teaching of practical skills and in facilitating the development of clinical competence in diploma nursing education in Ghana, a low-resource setting.
Methods: A qualitative descriptive design was used in this study. Nine nurse educators tasked with teaching practical skills and facilitating the development of clinical competence from three accredited diploma-awarding public nursing colleges – one in each of the three geographical zones of Ghana – were purposively sampled and interviewed using a semi-structured interview guide. The data were analysed with the aid of ATLAS.ti software through the thematic framework approach of qualitative data analysis.
Results: Four themes, namely nurse educator and student factors, skills learning environment factors, institutional challenges, and regulatory issues, were identified and described the challenges of practical skills teaching and clinical competence development confronting nurse educators in the study setting.
Conclusion: To address these challenges, policy measures should be implemented to ensure adequate national investment in nursing education and incentives to promote nurse educator development and performance. Nurse educators and their labour union should therefore strongly advocate for this transformation in nursing education.
The National Institute of Nursing Research (NINR) has a Friends group. This organization, the Friends of the National Institute of Nursing Research (FNINR), has been in place for over 20 years. It serves as a bold voice to communicate the impact of NINR's work to elevate nursing science, improve lives, while advancing the nation's health. FNINR's mission is to provide resources to support nursing research and advance the mission of the NINR. In 2013, the FNINR led the creation, development, and growth of an Ambassadors Program. The Ambassador Program is a group of committed individuals who are willing to serve as advocates of the NINR. Chosen through an application process reviewed by the FNINR Advocacy Committee of the FNINR Board, these selected Ambassadors work to influence Congress and advocate for the goals and visions of the NINR. This designation was initially limited to an elite group, and peer networking and communication was built into the program. The goal of the FNINR Ambassadors Program is to extend the reach of advocacy efforts for improving the funding and knowledge about the NINR. Thirty ambassadors across the country are working to expand knowledge and educate stakeholders about the impact of nursing science on the health of the country. This article describes the process the FNINR conducted to develop the Ambassadors Program, and the outcomes associated with this program.
The American Nurses Association (ANA) Code of Ethics for Nurses With Interpretive Statements informs decision making about ethical violations by nurses and nursing education programs. The Code is the nursing profession's ethical standard of practice and nursing's contract with society. Nurse practice acts (NPAs) and the standards of practice are the profession's legal standard. This article describes the nine provisions of the Code and provides cases of ethical violations and the disciplinary actions that were taken. The intent of this article is to serve as an educational resource on how the Code can be used with NPAs to support nurse regulators in their decision making.
Political astuteness, including awareness, knowledge, and involvement, is necessary if nurses are to engage in policy advocacy-a vital aspect of the nursing profession. However, little is known about the effects of learning activities, such as legislative days, on political astuteness. The purpose of this research was to determine if political astuteness changed after participants attended a state nurse legislative day. Pre and post data were collected from participants in two studies (N = 80 and N = 34) using the Political Astuteness Inventory (PAI). Political astuteness scores were significantly higher after participants attended legislative day as compared to before. Age and educational rank were positively correlated with political astuteness. Experiential activities such as attending nurse legislative days that offer opportunities to learn policy advocacy skills can enhance knowledge of and participation in the policy process.
Sumario: Managing complex change -- The demand system: forces in the environment -- Dynamics of organizations: where change occurs -- The change process: why change? -- Defining the future state -- Assessing the present: benchmarks for change -- Getting from here to there: transition management -- Commitment planning and strategies -- Managing complexity
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The Voice of Florence Nightingale on Advocacy
Louise C. Selanders, RN, EdD, FAAN; Patrick C. Crane, MSN, RN (January 31, 2012)
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Jennifer H. Matthews, PhD, RN, A-CNS, CNE, FAAN (January 31, 2012)
Advocating for Nurses and Nursing
Karen Tomajan, MS, RN, NEA-BC (January 31, 2012)
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