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Registered nurses comprise the largest health care workforce in the United States. In annual surveys, nurses also rank as the most trusted profession. They work at the bedside, in the community, in hospitals, homes and care settings. They work with patients, families, communities and organizations. Their work on the front lines means they are the primary point of contact for patients and they operate at the first level of decision-making. “By virtue of its numbers and adaptive capacity, the nursing profession has the potential to effect wide-reaching changes in the healthcare system.” (IOM Report 2010)

Despite this key role, nurses are often overlooked for the highest levels of organizational leadership. A 2010 survey of more than 1000 hospital boards found that only 6% of board members were nurses (American Hospital Association 2010). A recent IFN survey reports that only 62.6% of health care institutions have nurses on their boards. Other research has shown that nurses are not viewed as leaders, and that such negative perceptions are the biggest barrier to nurse leadership (Robert Wood Johnson Foundation 2010). Moreover, many nurses themselves often do not recognize the leadership skills they possess or may acquire, often conflating “leadership” and “management.”

A failure to unlock the leadership talent of American nurses will limit the health care system’s ability to adapt to the ongoing challenges it faces. Nurses are uniquely positioned to evaluate the impact of policies and procedures, generate learning opportunities for quality improvement, provide innovative solutions, and mobilize a wide range of constituents to meet new demands. And even beyond health care institutions and nursing organizations, with appropriate training, resources, and outreach, nurses can bring their skills and experience to benefit other sectors.

This initiative addresses recommendations contained in the Institute of Medicine’s Future of Nursing Report (2010). Recommendation 7 calls on nurse associations to “provide leadership development, mentoring programs, and opportunities to lead for all their members.” Accordingly, the ANA Leadership Institute supports the nursing profession to assume leadership positions to lead change and advance health regardless of their functional role. Every nurse can lead from where she serves, and many will choose to seek executive, board, or other advanced leadership roles.

Efforts to cultivate and promote leaders within the nursing profession—from the front lines of care to the boardroom—will prepare nurses with the skills needed to help improve health care and advance their profession. As leaders, nurses must act as full partners in redesign efforts, be account¬able for their own contributions to delivering high-quality care, and work collaboratively with leaders from other health professions. (The Future of Nursing, IOM Report Brief, October 2010)

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